SPECIAL EDITION: Updated GLP-1 Informed Consent Guide!

MSSI is excited to announce the release of a newly updated version of our Informed Consent Guide for GLP-1 Agonist Medications, authored by MSSI Advocacy Co-leads Jackie Liu and Marisa Langton (now an MSSI alum)! The goal of this document is to provide patients and healthcare professionals with a comprehensive, evidence-based resource outlining the risks and benefits of using GLP-1 receptor agonists for weight loss.

Originally released in 2023, the document has been revised to reflect ongoing research about the effects of GLP-1s. The updated version addresses common claims about the effects of GLP-1s on body weight and metabolic health, new and emerging side effects of GLP-1s, and the use of GLP-1s for indications other than diabetes or weight loss. The informed consent guide also provides alternative ways for patients to care for their bodies without pursuing weight loss and important considerations for patients who decide to take a GLP-1.

We hope the updated GLP-1 Agonist Informed Consent Guide will be a helpful resource for patients and healthcare professionals navigating the evolving landscape of research surrounding these medications.

You can find the updated resource on the MSSI website, or click below to download a PDF version!

MSSI would especially like to thank the members of our Advisory Board who have contributed to reviewing the data on GLP-1s and updating this document.

Other informed consent guides including bariatric surgery and pediatric weight loss can also be found on the MSSI website.

In this issue:

• Attention Medical Students — Start a MSSI Chapter At Your School!

• Book Recommendation: Weight-Inclusive Menopause Care

• Featured Research Article: Addressing Weight Stigma in Medical Education

• Upcoming AWSIM Events

Attention Medical Students! Interested in Starting a MSSI Chapter at your School?

Congratulations to all the first-year medical students who are starting their medical school journey this summer! If you are passionate about weight-inclusive medicine but don’t see it represented in your school’s student organizations or curriculum, consider starting a chapter of MSSI at your school!

Click below to 1) form a chapter of Medical Students for Size Inclusivity (MSSI) at your school, or 2) affiliate an existing organization at your school with MSSI. Once received, a member of MSSI will reach out with additional details, and our Chapter & Affiliate Application form! 

Current Chapters & Affiliates:

• MSSI at Hackensack Meridian School of Medicine

• MSSI at University of Minnesota – Twin Cities Medical School (@mssi_umn)

• Health Professional Students for Size Inclusivity, an Affiliate of MSSI at University of California San Francisco School of Medicine

• Size Inclusivity in Medicine at University of Wisconsin – School of Medicine and Public Health, an Affiliate of MSSI

• MSSI at Washington State University Elson S. Floyd College of Medicine

• MSSI at Tufts University School of Medicine

• MSSI at University of Nevada Reno SOM

• MSSI at Cooper Medical School of Rowan University

• MSSI at Frank H. Netter MD School of Medicine at Quinnipiac University (@mssi_netter)

• Medical and Dental Students for Size Inclusivity at Harvard Medical School, an Affiliate of MSSI

• Columbia Students for Size Inclusivity, An Affiliate of MSSI

• MSSI at University of Washington School of Medicine

• MSSI at UC Davis School of Medicine

• MSSI at Albany Medical College

• MSSI at University of British Columbia

• Students for Body Acceptance and Food Freedom (SBAFF) at Oregon Health & Science University, An Affiliate of MSSI

• MSSI at University of Colorado School of Medicine

• MSSI at Columbia University Vagelos College of Physicians and Surgeons

• MSSI at University of Illinois Chicago College of Medicine

Book Recommendation: A Woman's Guide to Menopause, Body Image, and Emotional Well-being at Midlife by Signe Darpinian

Perimenopause and menopause are often accompanied by changes in weight and body composition, mood, and overall health—changes that diet culture frequently frames as problems to be "fixed" through weight loss.

In her new book, A Woman’s Guide to Menopause, Body Image, and Emotional Well-being at Midlife, Licensed Marriage and Family Therapist (LMFT) and Certified Eating Disorder Specialist (CEDS) Signe Darpinian equips readers with strategies to navigate menopause through a weight-inclusive lens. Incorporating guidance from Menopause Society Certified Practitioners (MSCPs) and registered dietitians, as well real-life stories from individuals with a range of experiences, Darpinian addresses topics including common menopausal symptoms, body changes, mood and sleep difficulties, and sexual health. This book empowers readers to understand the physical and psychological changes that happen during menopause and advocate for themselves with healthcare professionals to achieve their own individualized version of well-being throughout the menopause transition.

Featured Research Article: “Addressing Weight Stigma in Medical Education: Insights and Strategies From a Nutrition Curriculum Review”

In a recent article published in the Journal of Medical Education and Curricular Development, Anna Harleen and colleagues analyzed prerecorded lectures from the nutrition curriculum at a large US medical school and identified common themes related to weight stigma found in course materials. Using these themes, the authors propose strategies to help educators create lectures that respect patients of all body sizes and reflect an evidence-based approach to the relationship between weight and medical conditions.

Five Themes of Weight Stigma found in Medical School Lectures:

1. Stigmatizing terminology and imagery:

   1. Unnecessarily negative language to describe obesity (ie, “grim”, “crisis”, “suffer with obesity”)

   2. Terminology such as “the obese” and “chunky kid”

   3. Photographs that depict people with larger bodies in dehumanizing ways

2. Assumptions regarding the controllability of weight

   1. Implication that obesity is due to personal decisions and/or actions (ie, “if you are going to be obese” and patients with obesity making the “right” choices)

   2. Description of weight loss as a “mental game”

3. Judgments about the behavior and health status of higher-weight patients

   1. Terminology such as “overeating” or “unmotivated”

   2. Comparison between having a larger body and “watching too much TV”

4. Overemphasis on the role of weight in overall health

   1. Imprecision with definitions (ie, use of “obesity” interchangeably with other health conditions such as diabetes)

   2. Suggestion that weight loss inherently results in improved well-being (ie, “patients are much healthier and happier as a result”)

   3. Assumption that obesity and fitness are oppositional

5. Statements that uphold socially constructed body ideals and moralize food/eating

   1. Creation of right/wrong dichotomy in the discussion of the “right” foods to be eating (ie, “crappy foods”, “right” choices)

   2. Promotion of thinness or weight loss as inherently healthy, better, happier, virtuous (ie, “better body”, “ideal body weight”)

Strategies to Reduce Weight Stigma in Medical Education:

1. Use neutral, precise language and avoid dehumanizing terms.

   1. Examples of neutral nonstigmatizing language to describe larger bodies include “higher-weight”, “larger-bodied”, “higher end of the weight spectrum”, and “person of size”.

2. Challenge weight-based assumptions and stereotypes

   1. Acknowledge the genetic, environmental, and social determinants of weight.

   2. Discuss challenges associated with weight loss maintenance such as decreased energy expenditure and weight cycling.

   3. Acknowledge the impact of weight stigma on health and healthcare (for example, research has shown that physicians provide suboptimal care to patients in larger bodies).

3. Emphasize multifactorial determinants of health.

   1. Discuss the physical and psychological risks associated with intentional weight loss and the importance of informed consent with respect to weight loss, including offering alternatives (ie, evidence-based treatments that would be provided to thinner patients).

   2. When presenting correlational data on obesity and disease risk, discuss key confounders such as physical activity and social determinants of health. Acknowledge health benefits of behavior change independent of body size.

   3. Discuss the history and limitations of the Body Mass Index (BMI).

4. Avoid reinforcing body ideals and moralizing food choices.

   1. Discuss the cultural and historical context of weight and dieting, including diet culture and racialized body ideals.

   2. Mitigate eating disorder triggers by using third-person language ("ie, “when research participants performed intermittent fasting) instead of second-person language (ie, “when you do intermittent fasting”).

5. Use content warnings when discussing potentially distressing weight-related topics.

   1. Focus on the impact of the content rather than the intent. For example, “Weight stigma is pervasive in medicine and, although we are working to mitigate stigma in the curriculum, this content may contain bias and we welcome any feedback”.

Are you a student or educator working to reduce weight stigma in your school’s curriculum? MSSI has a Lecture Analysis Tool designed to help you evaluate lectures for weight bias and identify areas for improvement.

Upcoming AWSIM Events!

AWSIM x WIDIC: When Weight Bias Shapes Reproductive Care
Tuesday, July 21, 2026
5:00–6:15 PM PT / 8:00–9:15 PM ET
Panelists: Dr. Naomi Busch, Dr. Anna Whelan, Simone Samuels, and Sarah O’Hara, RD

A live virtual panel exploring how weight-centered assumptions shape reproductive health care and what clinicians can do differently. Free for AWSIM members, WIDIC (Weight Inclusive Dietitians in Canada) members, and students.

Save the Date! AWSIM Fall Symposium 2026
Wednesday, November 18, 2026
10:00 AM–2:00 PM PT / 1:00–5:00 PM ET
More details coming soon!

This newsletter was authored by MSSI member Megan Coolahan (Tufts University School of Medicine).

In this issue:

• DEADLINE TODAY: NAAFA Research Scholarship

• Size-Inclusive Primary Care Competencies

• Featured Research Article: Associations of Obesity with Chronic Disease and Mortality

• Upcoming AWSIM Events

• Find us on Instagram!

LAST CHANCE: NAAFA Dr. Paul Ernsberger Research Scholarship!

The National Association for the Advancement of Fat Acceptance (NAAFA) is accepting applications for the Dr. Paul Ernsberger Research Scholarship until June 1, 2026. Scholarships are available for research graduate students within specified areas of concentration in scientific research, including nutrition and higher weight people, metabolic syndrome, weight cycling, medical harm from being obsessed with weight loss, and medical harm from the bias of physicians.

Up to three scholarships in the amount of $2,500 will be awarded.

Prioritization will be given to applicants of marginalized identity (POC, LGBTQIA+, disabled, fat/superfat) and those who demonstrate financial need. Scholarship will be paid directly to the graduate student.

REQUIREMENTS:

• Online application

• Transcripts (unofficial are acceptable)

• Proof of enrollment

• Recommendation/Reference form(s) - At least one recommendation/reference other than your advisor

• Copy of your FAFSA Student Aid Report

TIMELINE:

• Filing deadline 6/1/26

• Decision letter and agreement sent by email by 7/7/26

• Returned signed agreements by 7/14/26

• Scholarship issued 7/21/26

New — Size-Inclusive Primary Care Competencies

We are excited to share a new resource created by MSSI advisor Krista Handfield, LICSW! The Size-Inclusive Primary Care Competencies are a set of guidelines designed to help primary care providers develop an ethical and evidence-based size-inclusive approach to patient care.

The seven competencies include:

1. Identify structural weight stigma and unlearn weight bias

2. Identify and address weight stigma

3. Address health concerns independent of weight

4. Focus on size-inclusive health enhancement and sustainable health behaviors

5. Provide informed consent regarding weight-focused interventions

6. Practice through an equity and trauma-informed lens

7. Promote a size-inclusive environment

Featured Research Article: “Associations of obesity, systemic inflammation, and hyperinsulinemia with the incidence of non-communicable chronic disease and mortality: A prospective cohort study”

In a recent article published in Diabetes, Obesity, and Metabolism, Natasha Wiebe et al. question long-held assumptions about the association between weight and chronic disease. While previous studies have shown associations between obesity and metabolic syndrome (Guh et al. 2009), these studies are limited by their failure to measure incident disease (the number of new cases of a disease that develop over a specific time period) and lack of population-representative sampling designs. Furthermore, high BMI has been associated with a lower risk of mortality in the US population compared to “normal” BMI when controlling for inflammation and hyperinsulinemia (Wiebe, Muntner, and Tonelli 2022). If obesity is associated with chronic disease, and chronic disease is associated with mortality, then why do higher-weight patients experience decreased mortality compared to their lower-weight counterparts? In their recent study, Wiebe and colleagues investigated this question by following a population-representative cohort of Canadian adults for an average of 6.7 years and tracking markers including BMI, C-reactive protein levels (a marker of inflammation), fasting insulin levels, incidence of non-communicable chronic diseases (NCDs), and all-cause mortality.

Key takeaways from the study:

• Inflammation and hyperinsulinemia were strongly associated with an increased risk of mortality.

• Initial results showed increased risk of death in those with elevated BMI. However, when controlling for inflammation and hyperinsulinemia, higher-weight individuals had lower all-cause mortality than those with normal BMI. This suggests that the increased risk of death in higher-weight individuals is likely due to inflammation and hyperinsulinemia rather than BMI itself. Notably, weight stigma is also associated with elevated inflammatory markers (Keirns et al. 2025).

• High BMI, inflammation, and hyperinsulinemia were all associated with increased risk of at least one non-communicable chronic disease. The authors found a significant positive association between elevated BMI and hypertension, a non-significant association with cardiovascular disease and type 2 diabetes, and an inverse association with cancer (individuals with higher BMI were less likely to develop cancer). Again, inflammation resulting from weight stigma and weight cycling may account for some of the association between high BMI and chronic disease.

• Critics argue that elevated BMI causes systemic inflammation and hyperinsulinemia. However, Wiebe and colleagues suggest that “changes in fasting insulin precede changes in weight and not the other way around.” This claim is supported by evidence from randomized trials showing that patients treated with exogenous insulin or sulfonylureas (which increase release of endogenous insulin) gain weight (Holman et al. 2007; UKPDS Group 1998). Conversely, patients who undergo bariatric surgery experience decreases in fasting insulin and inflammatory markers prior to weight loss (Abbasi 2017).

• Adipose tissue has critical metabolic and immune functions, suggesting that “obesity” may “act as a protective mediator … and temper acute exacerbations of NCDs.”

• “As there are more people with metabolic syndrome without obesity than with obesity, future research should prioritize the study of how to best diagnose, monitor, and treat inflammation and hyperinsulinemia rather than obesity.”

Click here for the full article! Ragen Chastain has also written a helpful analysis of the article which can be found here.

Upcoming AWSIM Events!

June 8, 2026: “When Weight Misleads: Rethinking Dermatologic Diagnosis and Care” with Dr. Zed Zha

Free for AWSIM members and students

$35 for non-members

Find us on Instagram!

Instagram post

This newsletter was authored by MSSI member Megan Coolahan (Tufts University School of Medicine).

In this issue:

• Contact Form for Graduating Members

• Introducing the 2026-2027 MSSI Leadership Team!

• MSSI Featured in “Diet Culture Rebel” Podcast

• Featured Article: “GLP-1 medications for weight-loss: a triumph of marketing over patient care”

• NAAFA Research Scholarship

• Upcoming AWSIM Events

ATTENTION 2026 Graduates — Please complete this form!

Congratulations to MSSI’s Class of 2026! If you are graduating medical school this year, please complete this form so we can stay in contact with you! Thank you for your contributions to advancing the movement of size inclusive medicine.

Introducing the 2026-2027 MSSI Leadership Team!

Last month, we celebrated our graduating members of MSSI who are finishing medical school and moving on to residency. We’re now excited to introduce the MSSI leadership team for the 2026-2027 year! We look forward to expanding our advocacy efforts, strengthening our community, and advancing meaningful change in medical education and patient care.

We invited our leadership team to share their favorite part of being involved in MSSI—read on to hear their perspectives!

Director: Jessica Rosenblum, Tufts University School of Medicine Class of 2027 “MSSI has been one of the highlights of my medical school journey — every time I switch to an MSSI task from studying, it allows me to stretch different parts of my brain and think deeply about the kind of doctor I want to become. It gives special meaning and purpose to the sometimes draining day-to-day of medical school. I am inspired every time I take part in an MSSI event — I always leave feeling more energized and more purposeful than when the event started. Grateful to everyone in this community!”

Secretary: April Ascher, University of Kansas School of Medicine, Class of 2028 “My passion for size-inclusive medicine stems from recognizing how weight bias can negatively impact patient care, leading to missed diagnoses and diminished trust. Through my involvement in Medical Students for Size Inclusivity, I strive to provide compassionate, evidence-based care that prioritizes dignity and recognizes health as multifactorial rather than defined by body size.”

Director of Chapters and Affiliates: Jillian Rhodes, Tufts University School of Medicine, Class of 2028 “MSSI provides me with a community of passionate people who, like me, are committed to a medical field free of anti-fat bias. I enjoy learning from my peers in MSSI and appreciate the opportunity to work together to amplify the field of size inclusive medicine.”

Co-Director of Communications: Andrea Albano, Tufts University School of Medicine, Class of 2028 “My favorite thing about MSSI is our community! I always feel re-inspired and full of energy after being in a space with like-minded, passionate, amazing people doing incredible work for fat liberation.”

Co-Director of Communications: Megan Coolahan, Tufts University School of Medicine Class of 2028 “My favorite part of being involved in MSSI is learning from the incredible work my peers are doing to advance weight-inclusive care in medical education and clinical care. Every event inspires me to think more critically about how I can help my future patients to pursue their vision of health outside the constraints of weight stigma and diet culture.”

Co-Chair of Curriculum and Education: Abigail Fraust, Drexel University College of Medicine, Class of 2027 “Participating in the MSSI community has transformed my desire for body acceptance and interest in holistic primary care into what I hope is a pillar of my future clinical practice. It has prompted me to reflect on my own beliefs, deepen my knowledge, and share that with others through the Curriculum committee. Also, it has sparked some interesting conversations with friends and family!”

Co-Chair of Curriculum and Education: Divya Vemulapalli, Frank H. Netter MD School of Medicine at Quinnipiac University, Class of 2027 “My favorite part of being involved in MSSI is the sense of community. It’s truly invigorating to be surrounded by inspiring, passionate people from different medical schools and professions, all united by a shared commitment to improving how we learn, teach, and practice healthcare.”

Co-Chair of Advocacy: Jackie Liu, Harvard Medical School, Class of 2027 “My favorite part about being in MSSI is the community that we share. Constantly fighting against anti-fat bias in medicine can be exhausting, so being able to meet and relate to other people who get it can be refreshing and rejuvenating. I also appreciate how we’re able to channel this energy into change.”

Co-Chair of Advocacy: Karen Linares Quintos, Charles R. Drew University of Medicine & Science College of Medicine, Class of 2029 “I leave every MSSI event inspired and motivated to eliminate weight bias in medicine. It’s empowering to know that medical students across the US and Canada believe everyone deserves quality healthcare, regardless of weight or body shape.”

MSSI Featured on “Diet Culture Rebel” Podcast

MSSI’s Co-Chair of Advocacy, Jackie Liu, was featured on a recent episode of “Diet Culture Rebel,” a podcast hosted by registered dietitian and certified intuitive eating counselor Bonnie Roney. In the episode, Jackie explains key differences between weight-centric and weight-neutral healthcare, the effect of weight stigma on healthcare access, and strategies patients can use to advocate for themselves at medical appointments.

Click below for the link to the episode:

251. How Medical Students for Size Inclusivity Are Breaking the Cycle of Weight-Centric Care (with Jackie Liu from MSSI)

Diet Culture Rebel Podcast · Episode

Spotify

Featured Article: “GLP-1 medications for weight-loss: a triumph of marketing over patient care”

In a recent article published in Fat Studies, researchers Ragen Chastain, Angela Meadows, and Louise Adams critically evaluate the data on the safety and efficacy of GLP-1 agonists for weight loss and analyze the numerous conflicts of interest and instances of regulatory misconduct that have occurred in the marketing of these drugs.

Key points from the article:

1. How effective are GLP-1 agonists?

• While the media portrays GLP-1 agonists as “miracle drugs” that produce drastic weight loss for the majority of people, the data tells a different story. In phase 3 clinical trials of semaglutide and tirzepatide, up to one-third of participants failed to lose 5% of their starting weight (a benchmark commonly used to define “clinically significant weight loss”) (Davies et al. 2021; Ryan et al. 2024).

• Patients on GLP-1 agonists typically experience a plateau of weight loss after about 1 year of taking the medication, sometimes accompanied by a slight rebound in weight. In the 4-year SELECT trial on semaglutide, the authors claim that weight stabilized after 65 weeks of treatment. However, only 10.5% of patients in the treatment arm remained in the study at follow-up, suggesting that these claims overestimate long-term weight maintenance (Ryan et al. 2024).

• In a 2023 press release, Novo Nordisk claimed that semaglutide reduced the risk of major adverse cardiovascular events by 20% in “overweight” and “obese” adults. However, this 20% reduction is actually a relative risk reduction rather than an absolute risk reduction — 8% of patients in the placebo group had a cardiovascular event compared to 6.5% of patients on semaglutide (Lincoff et al. 2023). Furthermore, the study population was 72% male and 84% white, and statistically significant results were not seen in women or Black and Hispanic people.

2. The impact of dosing for weight loss

• Weight-loss formulations of GLP-1 agonists are given at higher doses than diabetes formulations, magnifying side effects for patients.

• In the 4-year SELECT trial of semaglutide, approximately 25% of participants could not tolerate the full 2.4mg dose for the duration of the study Ryan et al. 2024; (Lincoff et al. 2023, supplementary materials).

• Common side effects such as nausea, diarrhea, constipation, and dizziness can lead to severe dehydration requiring hospitalization if untreated (MHRA 2024).

• GLP-1 agonists can interfere with absorption of other medications requiring stable blood concentrations, including anticonvulsants, psychotropics, and antihypertensives. They also impact absorption of medications with narrow therapeutic windows, such as warfarin, lithium, SSRIs, antipsychotics, and digoxin (Lilly 2025b; Novo Nordisk 2024).

• The number of deaths attributed to GLP-1 agonists (Markey et al. 2025, FDA 2025) already exceeds that of earlier weight-loss drugs that were withdrawn due to safety concerns (Rodgers, Tschöp, and Wilding 2012).

3. Marketing “obesity”

• Authors of the GLP-1 clinical trial publications work for the drug manufacturers or have accepted millions of dollars in payments from them (Chastain 2024a, 2024b, 2025)

• Novo Nordisk has invested millions of dollars in creating research coalitions, lobbying organizations, and patient advocacy groups to promote their agenda of obesity as a chronic disease requiring lifelong treatment (Das and Ungoed-Thomas 2023).

• Novo Nordisk has a long history of misconduct, including a two-year suspension from the Association of the British Pharmaceutical Industry due to inappropriate marketing of liraglutide to healthcare providers (Mulinari, Pashley and Ozieranski 2024) and a $58.65 million fine from the FDA in 2010 for deliberately minimizing the risk of thyroid cancer in patients taking liraglutide (Mercedes 2021).

Call for Applications: NAAFA Research Scholarship

The National Association for the Advancement of Fat Acceptance (NAAFA) is accepting applications for the Dr. Paul Ernsberger Research Scholarship until June 1, 2026. Scholarships are available for research graduate students within specified areas of concentration in scientific research, including nutrition and higher weight people, metabolic syndrome, weight cycling, medical harm from being obsessed with weight loss, and medical harm from the bias of physicians.

Upcoming AWSIM Events!

May 8, 2026: AWSIM First Annual Scientific & Member Assembly

Student Registration Cost: $20

For 20% off registration, use discount code SOCIAL10

If you are a medical student interested in attending but the registration cost poses a barrier, please contact info@awsim.org.

May 22, 2026: “When Weight Becomes the Wrong Target: Transitioning from Obesity Medicine to Weight-Inclusive Care” with Dr. Michelle Tubman

Free for AWSIM members and students

$35 for non-members

This newsletter was authored by MSSI member Megan Coolahan (Tufts University School of Medicine)

In this issue:

• Match Day 2026: Congratulations to our MSSI Alumni!

• Save the Date! MSSI Match Panel

• Featured Article: “Beyond BMI” by Dr. Mara Gordon

• Upcoming AWSIM Events

Match Day 2026: Celebrating our MSSI Alumni!

We are thrilled to celebrate the accomplishments of our MSSI members who matched into residency! We are so proud of this year’s graduates and excited to see them carry the mission of size inclusivity into residency programs across the country.

Read on to learn where our graduating members are headed for residency and how they plan to incorporate size-inclusive medicine into their future practice.

Rebecca Case Medical School: Cooper Medical School of Rowan University Residency: Internal Medicine at Rutgers Health Robert Wood Johnson Medical School One way that you plan to incorporate weight-inclusive care into your future practice: “I will continue to use size-inclusive language with colleagues and patients to address weight bias and create a safe space for all of my patients.”

Syd Klumb Medical School: Rocky Vista University, CO Residency: Child Neurology at University of Utah Health

Marisa Langton Medical School: Drexel University College of Medicine Residency: Internal Medicine at Thomas Jefferson One way that you plan to incorporate weight-inclusive care into your future practice: “I plan to incorporate weight-inclusive care into my career by modeling it in clinical practice and sharing its principles with co-residents and colleagues, helping to shift the focus from weight to overall health. In doing so, I aim to advocate for clinical environments and resources that make patients of all body sizes feel safe, respected and compassionately cared for.”

Sophie Lalonde-Bester Medical School: University of Alberta Residency: Family Medicine at University of Alberta Red Deer One way that you plan to incorporate weight-inclusive care into your future practice: “I’m really looking forward to building longitudinal relationships with patients in family medicine and creating a space where they feel heard and supported. I’m excited to be entering a specialty that allows me to focus on preventive care, health-promoting behaviours, and patient advocacy. I also plan to continue my research to improve screening for eating disorders, particularly in those with polycystic ovarian syndrome.”

Taylor Lees Medical School: University of Minnesota Medical School Residency: Emergency and Internal Medicine at Ohio State University One way that you plan to incorporate weight-inclusive care into your future practice: “Weight-inclusive care has been and will continue to be a common thread throughout all of my patient interactions rather than an isolated skill I only occasionally incorporate. All patients deserve access to non-biased healthcare without being shamed, blamed, or othered for the shape or size of their body. The way this shows up will look slightly different in emergency and internal medicine, but both will require being aware of patients' harmful past experiences with bias in healthcare settings, moving away from weight-centric models of care, and focusing on accessible health promoting behaviors.”

Jay Liu Medical School: Stanford University School of Medicine Residency: Family Medicine at Contra Costa Regional Medical Center One way that you plan to incorporate weight-inclusive care into your future practice: “I hope to become a full-spectrum primary care physician capable of providing equitable, accessible, skillful, and size-inclusive care in both the hospital and the clinic. Everyone deserves to feel safe with their doctor and to pursue health on their own terms, and I hope to walk with them on that journey.”

Laurel Neufeld Medical School: University of Minnesota Residency: Family Medicine at Smileys One way that you plan to incorporate weight-inclusive care into your future practice: “Be in community with local organizers! Follow my patients’ lead!”

Samantha Temucin Medical School: Philadelphia College of Osteopathic Medicine Residency: General Surgery at Jefferson Abington Hospital One way that you plan to incorporate weight-inclusive care into your future practice: “I plan to ensure a safe environment in the operating room and discourage any harmful and ill-informed comments regarding various body sizes. I hope to educate myself on best considerations for surgery in larger bodies and ensure equal access to treatment for all!”

SAVE THE DATE: MSSI Match Panel

Please join us in celebrating our graduating M4s at the MSSI Match Panel on Tuesday, April 14th at 8-9pm EST. We will be joined by recently matched M4s, residents, and MSSI alumni. Get all your questions answered and hear how size inclusivity impacted their career decisions and the application process.

Please note, this event is intended for medical students and residents/fellows only.

Time Conversion:

• Tue, April 14, 2026 7:00 pm Central Time 

• Tue, April 14, 2026 6:00 pm Mountain Time, & Alberta

• Tue, April 14, 2026 5:00 pm AZ, Pacific Time, Vancouver

• Wed, April 15, 2026 12:00 pm AEDT Melbourne Australia

• Wed, April 15, 2026 1:00 am GMT Dublin Ireland

Click here for the meeting link and registration.

Featured Article: “Beyond BMI: What to talk with your doctor about besides weight”

In a recent NPR article, size-inclusive primary care physician Dr. Mara Gordon highlights strategies for moving beyond weight-centric care and discusses alternative approaches to assessing health beyond body mass index (BMI). Her insights offer practical guidance for how we, as future physicians, can foster more patient-centered and size-inclusive clinical conversations.

Reframing Weight-Centered Conversations in Clinical Practice

Recognize the limitations of BMI
BMI was originally developed as a population-level measure, not an indicator of individual health. Recent reports by the American Medical Association and The Lancet have emphasized its significant limitations. As clinicians, this underscores the importance of avoiding overreliance on BMI when assessing patient health.

Be thoughtful about routine weigh-ins
Weight is often treated as a standard vital sign, but it is not clinically necessary at every visit. When obtaining a patient’s weight, consider whether it will meaningfully impact management (e.g., medication dosing), and be prepared to explain its relevance.

Focus on health behaviors and individualized goals
Encouraging sustainable health behaviors—such as adequate sleep, regular movement, balanced nutrition, and mental health care—can be more meaningful than focusing solely on weight. Patient goals will vary across contexts and life stages, and care plans should reflect that flexibility.

Clinical Metrics Beyond BMI

Glycemic markers
Hemoglobin A1c (HbA1c) provides a longitudinal measure of blood glucose over ~3 months and is a key tool in assessing diabetes risk and management. Importantly, improvements in glycemic control can occur with behavioral changes independent of weight loss.

Cardiovascular risk assessment
Tools such as the ASCVD Risk Estimator and PREVENT calculator offer a more comprehensive evaluation of cardiovascular risk by incorporating multiple clinical variables rather than relying on weight alone.

Age-appropriate cancer screening
Ensuring patients are up-to-date on recommended screenings (e.g., cervical, breast, and colorectal cancer) is a critical component of preventive care and often more impactful than weight-focused interventions.

Upcoming AWSIM Events!

May 8, 2026: AWSIM First Annual Scientific & Member Assembly

This inaugural scientific assembly brings together clinicians, educators, researchers, trainees, and community partners committed to advancing weight-inclusive care. Beyond sharing evidence, this space is designed to foster meaningful connection, dialogue, and collaboration—creating a community where ideas are exchanged, perspectives are challenged, and collective learning moves the field forward. Participants will also have the option to engage in sequential small-group discussions with the same group throughout the day, intentionally designed to support deeper dialogue and build lasting professional connections within the AWSIM community.

Student Registration Cost: $20

For 20% off registration, use discount code SOCIAL10

If you are a medical student interested in attending but the registration cost poses a barrier, please contact info@awsim.org.

This newsletter was authored by MSSI member Megan Coolahan (Tufts University School of Medicine).

In this issue:

• Introducing the New MSSI Leadership Team!

• Save the Date! Spring Advisor Meeting

• Eating Disorder Awareness Week 2026

• BMI as a Barrier to Accessing Abortion Care

• Upcoming AWSIM Events

Introducing the 2026/2027 MSSI Leadership Team!

This year marks an exciting transition for Medical Students for Size Inclusivity (MSSI) as we celebrate over 20 of our members graduating medical school and moving on to residency! Our alumni have been instrumental in advocating for weight-inclusive healthcare, and we know they will continue to champion this work in their future practices.

With this transition, we are thrilled to introduce our new leadership team, a passionate group of medical students dedicated to continuing MSSI’s mission. As we step into this next chapter, we look forward to expanding our advocacy efforts, growing our community, and pushing for change in medical education and patient care. Stay tuned for updates on our initiatives, upcoming events, and ways to get involved!

Director

• Jessica Rosenblum, Tufts University School of Medicine, Class of 2027

Secretary

• April Ascher, University of Kansas School of Medicine, Class of 2028

Director of Chapters & Affiliates

• Jillian Rhodes, Tufts University School of Medicine, Class of 2028

Co-Directors of Communications

• Andrea Albano, Tufts University School of Medicine, Class of 2028

• Megan Coolahan, Tufts University School of Medicine, Class of 2028

Research - Student Lead

• Joe Morrison, UC Davis School of Medicine, Class of 2031 (MD/PhD)

Co-Chairs of Curriculum/Education

• Abigail Fraust, Drexel University College of Medicine, Class of 2027

• Divya Vemulapalli, Frank H. Netter MD School of Medicine at Quinnipiac University, Class of 2027

Co-Chairs of Advocacy

• Jackie Liu, Harvard Medical School, Class of 2027

• Karen Linares Quintos, Charles R. Drew University of Medicine & Science College of Medicine, Class of 2029

SAVE THE DATE: Spring Advisor Meeting

You are invited to join MSSI for our March Advisory Meeting! We will be hosting the meeting on Tuesday March 24th at 8-9pm EST. MSSI student leaders will share updates on ongoing projects and ask for feedback from MSSI advisors, other MSSI students, AWSIM clinicians, and other members of the weight-inclusive community.

MSSI advisory meetings are also an informal opportunity to mingle, network and brainstorm in community - we look forward to seeing you there!

Time Conversion:

• Tue, March 24, 2026 7:00 pm Central Time 

• Tue, March 24, 2026 6:00 pm Mountain Time, & Alberta

• Tue, March 24, 2026 5:00 pm AZ, Pacific Time, Vancouver

• Wed, March 25, 2026 12:00 pm AEDT Melbourne Australia

• Wed, March 25, 2026 1:00 am GMT Dublin Ireland

Meeting link and registration: https://tufts.zoom.us/meeting/register/iU76HPjzQu6fLJR2nB9wyw#/registration

Eating Disorder Awareness Week 2026

Eating Disorder Awareness Week generally takes place at the end of February around the world, and February 23-March 1 this year in the US. We know that through open, supportive dialogue, we, as medical students, can help break the shame and silence that affect the millions of people living with an eating disorder; and the millions of others who are struggling with food and weight preoccupation. 

Eating Disorder Awareness Week is a time to raise awareness about eating disorders, their impact and to shed light on the dangerous and pervasive myths that surround them. It is a time of year when folks can learn more about eating disorders and about the resources that are available for individuals and family members who are impacted by them.

At MSSI, we firmly believe that size inclusion and fat liberation are key components of ED advocacy.

If you’re currently struggling with an eating disorder or disordered eating yourself, please know that support is available to you. There are many ways to get the help you need, from free groups to treatment and much more. Check out some of our preferred resources from Project HEAL.

You can support Project HEAL’s fundraiser at the link to help increase access to eating disorder care in the US.

You can also browse body-safe and Health at Every Size® (HAES) books and resources for patients, family and clinicians on eating disorder recovery and healing. This list compiled by Lindley at Body Liberation Photos is wonderful.

BMI as a Barrier to Accessing Abortion Care

A recent article by Gabriella Gladney in The 19th highlighted an issue many of us may not have previously considered: BMI cutoffs functioning as barriers to abortion access.

The story centres on patients like Elie Liakopoulos, who sought a surgical abortion in Oregon (a state where abortion is legally protected) only to be told she could not receive care at a clinic because her BMI exceeded their threshold. She later secured care elsewhere, but her body size again shaped her experience through altered anesthesia practices, poorly managed pain, and a traumatic procedural experience attributed to her BMI.

What does the evidence say?

The article references the following research:

• A 2025 systematic review in Obstetrics & Gynecology found no increased risk of complications from surgical abortion associated with obesity, even after adjusting for age and gestational age.

• A 2019 study in Perspectives on Sexual and Reproductive Health similarly found no difference in complication rates by BMI, though patients with higher BMIs were more likely to be referred out resulting in delays and increased costs.

Dr. Noora Siddiqui, a family medicine physician in Philadelphia and a fellow with Physicians for Reproductive Health, states in the article: “There’s nothing physiologically that should keep you from being able to perform these safe procedures or medications”.

BMI as a gatekeeper

BMI was never designed as an individualized clinical decision-making tool. It is a population-level epidemiologic measure, developed using data from White European men. Yet in practice, it is often used as a shorthand proxy for anesthetic risk, procedural difficulty, or facility limitations.

In abortion care, these cutoffs may reflect lack of provider training in caring for patients in larger bodies, insurance-driven anesthesia policies, equipment limitations (procedure tables, imaging modalities, BP cuffs, gowns, etc), and institutional risk aversion.

But when BMI becomes a hard exclusion criterion rather than part of individualized risk assessment, it functions as gatekeeping.

And abortion care is time-sensitive in nature, with delays having the potential to result in more days of pregnancy-related symptoms, increased procedural complexity, additional travel/childcare/lost wages, and emotional distress. Where structural barriers to abortion are already profound, especially in the USA, BMI cutoffs represent yet another layer of inequity.

Individualized clinical risk vs. structural bias

To be clear, anesthesia carries real risks. Providers must assess airway anatomy, co-morbidities, and many other factors. But risk stratification should be individualized, rather than determined by arbitrary BMI cutoffs unsupported by complication data.

When BMI is used as a disqualifier rather than a contextual data point, it shifts from being a screening tool to being a structural barrier.

What this means for us medical students:

As future physicians, we should be asking:

• Are we using BMI to inform care or to limit it?

• Does our clinical reasoning rely on evidence or on inherited norms?

• Do our clinics have the equipment and training to serve patients across body sizes?

• When we refer out, are we mitigating harm or contributing to delay?

The final quote from the article reads: “…Fat people make up more than a third of this country. If all of us are being treated more poorly simply because our bodies are larger, that’s obviously a systemic problem…”

Upcoming AWSIM Events!

This newsletter was authored by MSSI member Sophie Lalonde-Bester (University of Alberta).

In this issue:

• MSSI x AWSIM Kickoff Meeting Recap

• APPLY NOW! Recruitment Call for MSSI Leadership Positions

• Research Feature: Weight Stigma in Healthcare Communication

• Call for Abstracts for the AWSIM Annual Scientific and Member Assembly

• Call for Abstracts for the 12th Annual International Weight Stigma Conference

MSSI x AWSIM 2026 Kickoff Recap: Connections and Future Directions

On January 20th, MSSI and our partner organization, the Association for Weight and Size Inclusive Medicine (AWSIM) kicked off the year with a very special & energizing virtual gathering. Open to all MSSI members, AWSIM members, and anyone curious about size-inclusive medicine, the kickoff was a space where we could share MSSI’s priorities for 2026, highlight upcoming events and collaborations, and outline ways to get involved in student leadership.

What made the evening truly special, though, was the community. The chat was truly popping off with people connecting, networking, and supporting one another’s work. We couldn’t keep up! It was so meaningful to feel such strong passion and enthusiasm from so many like-minded folks. Together, we brainstormed exciting new directions for MSSI and AWSIM’s collaboration, including early conversations about a potential mentorship program. We also put out a call for new MSSI student leaders as several current members prepare to graduate and begin residency.

We were struck by the diversity of attendees. Allied health professionals, social science colleagues, and motivated pre-meds joined the conversation, opening the door to future interdisciplinary collaboration.

All in all, it was a powerful reminder of the strength of this community and the momentum behind weight- and size-inclusive medicine. We look forward to reinstating quarterly community meetings to keep these conversations going. We’re so grateful to everyone who joined and helped make the kickoff such a meaningful start to 2026!! Stay tuned for upcoming events this spring including a match day panel featuring some of MSSI’s graduating M4s!

MSSI NATIONAL LEADERSHIP APPLICATIONS NOW OPEN

Dear MSSI students,

We are happy to announce that we are recruiting our next generation of leaders of the national MSSI organization, and the application is NOW OPEN!!! Applications are due Sunday, February 8th 11:59pm EST

Application

Position Descriptions

Want to get more involved with our committees, without holding a leadership role? Complete the committee interest form instead. 

Questions? Don’t hesitate to reach out sizeinclusivemedicine@gmail.com or to our Co-Directors Jess or Anna (jessica.rosenblum@tufts.edu, wengyn85@rowan.edu).

Research Feature: Weight Stigma in Healthcare Communication

We’re excited to highlight a new peer-reviewed publication co-authored by our MSSI Co-President, Jessica Rosenblum, published in Health Communication in January 2026: “It Makes Me Feel Bad About the World of Medicine, Makes Me Not Want to Go”: Understanding Weight Stigma, Disconfirming Messages and Health Outcomes.

Darnell WH, Chunduru J, Rosenblum JL, Lambert South A, Altman W. "It Makes Me Feel Bad About the World of Medicine, Makes Me Not Want to Go": Understanding Weight Stigma, Disconfirming Messages and Health Outcomes. Health Commun. 2026 Jan 8:1-15. doi: 10.1080/10410236.2025.2608900. Epub ahead of print. PMID: 41504278.

This qualitative study explores how weight stigma shows up in healthcare communication and why it matters. Through in-depth interviews and focus groups with 25 individuals in larger bodies (ages 24-71), the authors examined patients’ experiences during weight-related conversations with healthcare providers. They found a powerful and troubling picture of how certain communication patterns can undermine care.

Two key forms of disconfirming communication emerged:

• Minimizing effort or struggle, where patients’ lived experiences, challenges, or health-promoting behaviours were dismissed or overlooked

• Undermining agency where patients felt talked over, disqualified as decision-makers, or reduced to their weight rather than treated as whole people

Importantly, these interactions weren’t just unpleasant. They were linked to real health consequences, including diminished trust in providers, emotional and psychological distress, disrupted or delayed care, and delayed diagnoses.

This work underscores that communication is not neutral. The way clinicians talk about weight and to people in larger bodies can either strengthen therapeutic relationships or actively push patients away from care.

Key takeaways for clinical practice include:

• Prioritize listening to a patient’s story, experiences, and health goals before offering advice

• Recognize that patient-centered communication is the gold standard of high-quality healthcare delivery

• Understand that patient agency is key when initiating conversations about weight

• Take responsibility to help prevent healthcare avoidance and care gaps resulting from weight-based discrimination

We’re incredibly proud to see members of our MSSI leadership team contributing to research that advances size-inclusive medicine and provides actionable insights for improving healthcare communication. Well done, Jessica!

Call for Abstracts: 1st AWSIM Annual Scientific and Member Assembly

Dear colleagues,

AWSIM is pleased to announce the Call for Abstracts for the 1st AWSIM Annual Scientific & Member Assembly, taking place Friday, May 8, 2026, as a fully virtual, one-day meeting.

This inaugural event marks a defining milestone for AWSIM. It brings together scientific exchange, interdisciplinary collaboration, and member governance to advance weight-inclusive, evidence-based care within medicine and health systems.

We invite submissions from clinicians, researchers, educators, trainees, and community partners whose work contributes to transforming care for people of all sizes.

Conference highlights include:

• Two keynote addresses on the future of weight-inclusive medicine, patient safety, advocacy, and systems-level change

• Four scientific sessions featuring selected oral presentations

• A virtual poster session during the lunch hour, with optional short pre-recorded videos

• Breakout and interest groups to foster professional connection and collaboration

• The AWSIM Annual Member Meeting, fulfilling governance responsibilities and shaping organizational priorities for 2026–2027

Abstract categories:

• Research

• Medical and Health Professions Education

• Clinical Practice

• Work in Progress (ideas, early findings, protocols)

• Cross-Cutting Edge (interdisciplinary, innovative, or community-grounded work)

Abstract guidelines:

• Maximum 250 words (excluding title)

• Optional: one table or one figure

• Required structure: objectives, methods, results (if applicable), conclusions

• Preferred format: single PDF

• Please indicate preferred presentation format (oral or poster)

• Submit via email to info@awsim.org with the subject line: Abstract Submission

Submission deadline: Rolling
Conference date: May 8,2026
Time: 10:00 AM–4:00 PM EST
Format: Fully virtual

We strongly encourage interdisciplinary and interprofessional submissions, as well as work that centers equity, lived experience, and innovation in stigma-reducing care. If you are unsure whether your work “fits,” we encourage you to submit.

Please feel free to share this call with colleagues and networks who may be interested.

We look forward to learning from your work and gathering as a community.

Warmly,
The Education Committee
Association for Weight and Size Inclusive Medicine
www.awsim.org

Call for Abstracts: 12th Annual International Weight Stigma Conference

13-14 JULY 2026 OSLO, NORWAY & ONLINE

Deadline for abstract submission: Rolling/May 31st

The Annual International Weight Stigma Conference is an interdisciplinary event that brings together scholars and practitioners from a range of backgrounds (e.g., public health, government and public policy, psychology, medicine, sociology, anthropology, allied health professions, education, sports and exercise science, social sciences, media studies, business, law, activism, and the lay public) to consider research, policy, rhetoric, and practice around the issue of weight stigma.

Abstracts can be for oral presentations (10 mins, including time for questions), posters, or other formats (symposia, workshops, seminars, creative sessions, etc.).

They invite contributions across a wide range of disciplines and methodological and theoretical approaches. International voices discussing the situation in countries other than the US are particularly welcome. Equally so are intersectional approaches and perspectives from other marginalized groups. We encourage submissions from scholars, practitioners, policy makers, and activists. Students are especially encouraged to submit proposals.

Judges’ Choice and People’s Choice prizes will be awarded for the best oral presentation and best poster.

Note, accepted presenters will be required to register for the conference and pay the registration fee. Bursaries may be available on a case-by-case basis.

Visit the abstract submission page for more information.

This newsletter was authored by MSSI members Sophie Lalonde-Bester (University of Alberta) and Jay Liu (Stanford University).

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Register here! https://zoom.us/meeting/register/AZI-JZLWQXeeY83qZlWM3Q

Tuesday, January 20, 2026

8:00–9:00 PM ET | 5:00–6:00 PM PT

All MSSI members are invited to the 2026 kickoff meeting, a virtual event open to anyone interested in learning more about MSSI and the Association for Weight and Size Inclusive Medicine (AWSIM).

This kickoff is designed to:

• Share MSSI’s plans and priorities for 2026

• Share upcoming events, projects, and collaborations

• Introduce MSSI committees and opportunities to get involved

• Highlight open MSSI student leadership roles

• Create space to connect, network, and build community

All are welcome!

In this issue:

• SAVE THE DATE: MSSI 2026 Kickoff!

• Recruitment call from MSSI National

• ED Holiday Resources

SAVE THE DATE: MSSI 2026 Kickoff!

Registration: https://zoom.us/meeting/register/AZI-JZLWQXeeY83qZlWM3Q

Tuesday, January 20, 2026

8:00–9:00 PM ET | 5:00–6:00 PM PT

All MSSI members are invited to the 2026 kickoff meeting, a virtual event open to anyone interested in learning more about MSSI and the Association for Weight and Size Inclusive Medicine (AWSIM).

This kickoff is designed to:

• Share MSSI’s plans and priorities for 2026

• Share upcoming events, projects, and collaborations

• Introduce MSSI committees and opportunities to get involved

• Highlight open MSSI student leadership roles

• Create space to connect, network, and build community

All are welcome!

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Recruitment Call for MSSI National Student Leaders

MSSI National is entering recruitment season and looking to onboard new student leaders! Current medical and health science students interested in shaping the future of size-inclusive care, getting involved in size-inclusive advocacy on a national level, or just looking to become more involved in our community are invited to apply.

Leadership positions opening up next year include (but are not limited to):

• Director of Chapter and Affiliates

• Director of Community Engagement and Education

• Newsletter Chair

• Advocacy Lead

• Curriculum and Education Lead

For more information, or to apply, email us at sizeinclusivemedicine@gmail.com.

ED Holiday Resources

• Eating Disorder Foundation’s 18+ Virtual Holiday Support Group on Dec 27 10AM MT

• Eating Recovery Center’s Holiday Support Series (Tuesdays 6PM MT)

• ANAD’s Holiday Resources (pop-up virtual support groups, holiday support email series, holiday help guides)

Screenshot from Feeding Your Soul Nutrition’s December Newsletter

This newsletter was authored by MSSI members Sophie Lalonde-Bester (University of Alberta) and Jay Liu (Stanford University).

In this issue:

• Event Recap: Columbia Students for Size Inclusivity Journal Club

• NEW MSSI Resource: Pediatric Weight-Management Informed Consent Project

• Evidence-Based Archives: GLP-1 Agonists and Eating Disorders

• Featured Article: Being an anti-diet doctor isn't radical by Dr. Mara Gordon

Event Recap: Columbia Students for Size Inclusivity Journal Club

Disclaimer: We use the terms “ob*sity” and “overw*ight” in our summaries when it is otherwise impossible to accurately describe findings from certain studies, due to the language and descriptors chosen by researchers. We acknowledge the inaccuracies and harms that these labels have perpetuated in medicine and society. Please keep your mental health in mind when reading, and feel free to reach out to us with any feedback or suggestions at any time!

Columbia Students for Size Inclusivity (CSSI) had their 3rd event of the semester on November 3rd! Vice President, Griffin Gowdy led a journal club discussion where the group critiqued the weight-centric paper from the Global BMI Mortality Collaboration, “Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents.”

The group used the article, “Flawed methods and inappropriate conclusions for the health policy on overweight and obesity: the Global BMI Mortality Collaboration meta-analysis” to build on their arguments critiquing the weight-centric paper. (Learn more through MSSI’s “Evidence-Based Archives” summary of this paper).

Arguments critiquing the Global BMI Mortality Collaboration meta-analysis include that they used highly selective, non-systematic data, excluded large portions of available data and deaths, relied on flawed analytic restrictions that were inadequately justified, and failed to properly address significant sources of bias like self-reported weights; as a result, its conclusions about overweight and obesity increasing mortality globally are unreliable and should not guide health policy or clinical decisions.

After participants critiqued the article, they were surprised at the major impact and broad recognition within the scientific and medical community that this paper holds. Despite the meaningful flaws in data inclusion and analysis that this paper was published in the Lancet, one of the highest-impact medical journals in the world and cited over 3300 times, indicating its use in subsequent research, reviews, and policy discussions.

During the journal club, we enjoyed some delicious food from a local restaurant, Native Noodles! 

NEW MSSI Resource: Pediatric Weight-Management Informed Consent Project

MSSI is excited to announce a NEW informed consent resource on Weight Management for Pediatric Populations, authored by MSSI Advocacy Co-leads Jackie Liu and Marisa Langton, Curriculum Committee member Allyssa Tomlin, and MSSI member Sydney Klumb!

This is a parent-facing resource describing and explaining the risks and benefits of different weight loss interventions that pediatricians may recommend, as well as weight-neutral approaches to supporting overall childhood health and wellbeing. In light of current AAP guidelines around management of childhood “o**sity” (read more about issues with the guidelines here), this document may help parents navigate potentially unsolicited advice on weight management for their child. While MSSI does not agree that weight and health are directly linked, we respect individual choices and the process of shared decision-making and hope that this resource will help guide trauma-informed and compassionate conversations.

Browse our other informed consent projects on GLP-1s and bariatric surgery.

MSSI is working on a version of this resource for kids! If you are interested in contributing to our work, please reach out to sizeinclusivemedicine@gmail.com.

Evidence-Based Archives

MSSI is excited to present another installment of “Evidence-Based Archives,” our monthly column highlighting and summarizing seminal research in the field of size-inclusive healthcare. In this section, we hope to celebrate our scholars, empower each other with knowledge, and stock up on citations for the next time we’re called upon to justify size-inclusive healthcare in the classroom, clinic or wards!

Content warning: Eating disorders, ob*sity, anti-fat language

Disclaimer: We use the terms “ob*sity” and “overw*ight” in our summaries when it is otherwise impossible to accurately describe findings from certain studies, due to the language and descriptors chosen by researchers. We acknowledge the inaccuracies and harms that these labels have perpetuated in medicine and society. Please keep your mental health in mind when reading, and feel free to reach out to us with any feedback or suggestions at any time!

This month’s highlight:  Bartel, S., McElroy, S. L., Levangie, D., & Keshen, A. (2024). Use of glucagon-like peptide-1 receptor agonists in eating disorder populations. The International journal of eating disorders, 57(2), 286–293. https://doi.org/10.1002/eat.24109

https://doi.org/10.1002/eat.24109

As GLP-1 receptor agonists (GLP-1RAs) like semaglutide, liraglutide, and tirzepatide continue to make headlines as “miracle” and “game-changing” weight-loss drugs, clinicians are increasingly encountering a challenging question: What do these medications mean for people with a history of eating disorders?

This month, we highlight a 2024 narrative review by Bartel et al. that synthesizes what is currently known and what remains unknown about GLP-1RAs in eating disorder (ED) populations.

Objectives of the review:

The authors synthesize the limited evidence available on GLP-1RAs and EDs. They discuss the potential risks and benefits, evidence on these medications in the management of binge eating, and directions for future research. They also provide readers with a practical guide for discussing GLP1-RAs with patients.

1. Potential harms: Could GLP-1RAs worsen ED symptoms?

The authors acknowledge that GLP-1RAs may worsen or trigger ED pathology by suppressing appetite, altering hunger and fullness cues, and promoting rapid weight loss. They also discuss that common side effects of these medications (i.e. GI upset, nausea) often result in reduced interest in eating, further enabling dietary restriction.

Much of this discussion is appropriately cautious, but also vague, reflecting the extremely limited evidence base. As The Cut recently reported, even non-ED-affected users describe concerning appetite blunting and emotional detachment from eating, underscoring the potential for serious risk in those with a pre-existing history of disordered eating.  

2. Potential ?benefits: Can GLP-1RAs treat binge eating?

The review summarizes existing literature exploring GLP-1RAs as a treatment for binge eating:

• Animal models: Two animal studies (Cao 2014, and Pierce-Messick & Pratt 2020) suggest GLP-1RAs may reduce binge eating behaviours.

• RCTs: The authors found only one randomized controlled trial (Allison 2023) that randomized twenty-seven participants with BED to liraglutide or placebo for 17 weeks. Liraglutide showed non-significant reductions in binge episodes but did result in greater weight loss. Study limitations were substantial, including randomization errors and low baseline binge frequency.

• Non-blinded trials:

  • One study (Robert 2015) randomized 44 adults with high Binge Eating Scale (BES) scores to liraglutide or diet/exercise groups for 12 weeks. They found liraglutide reduced BES scores and body weight.

  • Another study (Da Porto 2020) randomized 60 adults with diabetes and BED to dulaglutide or gliclazide for 12 weeks. Those with dulaglutide therapy had greater reductions in BES scores and body weight.

• Retrospective cohort: One study (Richards 2023) suggested semaglutide may reduce binge eating symptoms more than other combinations of “weight loss” medications including topiramate, lisdexamfetamine dimesylate, or others.

Across studies, improvements in binge eating were often tied to weight loss, raising the question of whether reductions reflected true BED remission or rather, shifts toward restrictive eating…

Studies to date share major limitations:

• Very small sample sizes

• Few RCTs

• Short study durations

• Outcome tools that poorly assess ED psychopathology

• No studies in anorexia nervosa, bulimia nervosa, ARFID (or any ED other than BED)

The authors of the review emphasize the need for rigorous trials that include validated measures of dietary restraint (not just weight-centric metrics that may falsely suggest remission), and longer term follow ups to capture possible rebound binge eating once medication effects diminish.

3. Are we adequately accounting for harm?

While Bartel et al. outline potential risks, their discussion of harms remains conservative. They conclude that there is insufficient evidence to support the use of GLP-1 mediations to treat ED symptoms at this time, and that, “…more research is required before negative or positive conclusions can be drawn about the impact of GLP-1As on EDs psychopathology”. In clinical practice, several of us MSSI students and clinicians have anecdotally seen a different picture.

Because EDs are deeply stigmatized and frequently undiagnosed in people living in larger bodies, many of our patients may not disclose or volunteer symptoms such as bingeing, purging, laxative misuse, or compulsive exercise. These patients are frequently prescribed GLP-1RAs without appropriate ED screening or counselling.

For individuals with a history of disordered eating, the appetite suppression and rapid weight loss induced by GLP-1RAs can:

• exacerbate existing ED symptoms

• trigger the onset of a new ED

• reinforce pathological restriction

• enable compensatory behaviours

• mask ED relapse behind “successful” weight loss

Clinicians are increasingly reporting cases where GLP-1 initiation precipitated severe deterioration or ED relapse after years of stability (Trollope-Kumar 2025). These events are serious and under-recognized.

Given the life-threatening medical and psychiatric risks associated with EDs, any medication that can precipitate or intensify restrictive behaviour warrants far greater caution than the current literature reflects.

So, should GLP-1RAs be contraindicated in people with a history of EDs?

Current guidelines and drug monographs do not list eating disorders as a contraindication to GLP-1 RA use.

However, based on growing evidence, clinical experience, and the well-documented risks of ED relapse and restriction, we suggest that at the very least:

• All patients should be screened for past or current ED symptoms before GLP-1RA initiation.

• Patients with ED histories should receive informed consent that includes discussion of potential ED risks (see MSSI’s informed consent resource here).

• Prescribers should be aware that EDs are common in higher-weight populations and are often hidden.

• Close monitoring should be routine and should include psychological assessment.

• ED specialists should be involved whenever possible.

Above all, care should prioritize patients’ relationships with food, movement, and their bodies, not weight-centric metrics.

References:

1. Bartel, S., McElroy, S. L., Levangie, D., & Keshen, A. (2024). Use of glucagon-like peptide-1 receptor agonists in eating disorder populations. The International journal of eating disorders, 57(2), 286–293. https://doi.org/10.1002/eat.24109

2. Davis, A. P. (2025, November 13). Life in beige. The Cut. https://www.thecut.com/article/glp-1-weight-loss-drugs-ozempic-sex-drive-side-effects.html  

3. Cao, X., Xu, P., Oyola, M. G., Xia, Y., Yan, X., Saito, K., Zou, F., Wang, C., Yang, Y., Hinton, A., Jr, Yan, C., Ding, H., Zhu, L., Yu, L., Yang, B., Feng, Y., Clegg, D. J., Khan, S., DiMarchi, R., Mani, S. K., … Xu, Y. (2014). Estrogens stimulate serotonin neurons to inhibit binge-like eating in mice. The Journal of clinical investigation, 124(10), 4351–4362. https://doi.org/10.1172/JCI74726

4. Pierce-Messick, Z., & Pratt, W. E. (2020). Glucagon-like peptide-1 receptors modulate the binge-like feeding induced by µ-opioid receptor stimulation of the nucleus accumbens in the rat. Neuroreport, 31(18), 1283–1288. https://doi.org/10.1097/WNR.0000000000001545

5. Allison, K. C., Chao, A. M., Bruzas, M. B., McCuen-Wurst, C., Jones, E., McAllister, C., Gruber, K., Berkowitz, R. I., Wadden, T. A., & Tronieri, J. S. (2022). A pilot randomized controlled trial of liraglutide 3.0 mg for binge eating disorder. Obesity science & practice, 9(2), 127–136. https://doi.org/10.1002/osp4.619

6. Robert, S. A., Rohana, A. G., Shah, S. A., Chinna, K., Wan Mohamud, W. N., & Kamaruddin, N. A. (2015). Improvement in binge eating in non-diabetic obese individuals after 3 months of treatment with liraglutide - A pilot study. Obesity research & clinical practice, 9(3), 301–304. https://doi.org/10.1016/j.orcp.2015.03.005

7. Da Porto, A., Casarsa, V., Colussi, G., Catena, C., Cavarape, A., & Sechi, L. (2020). Dulaglutide reduces binge episodes in type 2 diabetic patients with binge eating disorder: A pilot study. Diabetes & metabolic syndrome, 14(4), 289–292. https://doi.org/10.1016/j.dsx.2020.03.009

8. Richards, J., Bang, N., Ratliff, E. L., Paszkowiak, M. A., Khorgami, Z., Khalsa, S. S., & Simmons, W. K. (2023). Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study. Obesity pillars, 7, 100080. https://doi.org/10.1016/j.obpill.2023.100080

9. Trollope-Kumar, K. (2025, August 27). RE: Eating Disorders and GLP-1 Agonists [Online forum]. CMAJ. https://www.cmaj.ca/content/re-eating-disorders-and-glp-1-agonists

10. Medical Students for Size Inclusivity. (2023, Nov.). GLP-1 Agonist Medications: Informed Consent Resource. https://sizeinclusivemedicine.org/glp1/

Thoughts?

We are open to feedback and interested in the lived experiences of our MSSI members. Have you referenced this article in your clinical work, used it to guide patient counseling, or used it to communicate with your colleagues? How did it go? 

Feel free to share your stories, reflections, expertise, and advice using the links below. With your permission, we may publish reflections in future installments of this column.

If you have a favorite article you’d like us to highlight in our next installment, feel free to submit it for consideration, also by using the link below! We look forward to hearing from you!

Featured Read: Being an anti-diet doctor isn't radical by Dr. Mara Gordon

One of our members came across this great article by Dr. Mara Gordon on why anti-diet care really isn’t a radical idea. It’s a quick, thoughtful read & we highly recommend.

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This newsletter was authored by MSSI members Sophie Lalonde-Bester (University of Alberta) and Jay Liu (Stanford University).

In this issue:

• NEW MSSI Resource: Pediatric Weight-Management Informed Consent Project

• Upcoming Event: MSSI Advocacy in Clerkships and Residency Interviews

• Reflections on AWSIM’s 2025 Fall Symposium

NEW MSSI Resource: Pediatric Weight-Management Informed Consent Project

MSSI is excited to announce a NEW informed consent resource on Weight Management for Pediatric Populations, authored by MSSI Advocacy Co-leads Jackie Liu and Marisa Langton, Curriculum Committee member Allyssa Tomlin, and MSSI member Sydney Klumb!

This is a parent-facing resource describing and explaining the risks and benefits of different weight loss interventions that pediatricians may recommend, as well as weight-neutral approaches to supporting overall childhood health and wellbeing. In light of current AAP guidelines around management of childhood “o**sity” (read more about issues with the guidelines here), this document may help parents navigate potentially unsolicited advice on weight management for their child. While MSSI does not agree that weight and health are directly linked, we respect individual choices and the process of shared decision-making and hope that this resource will help guide trauma-informed and compassionate conversations.

Browse our other informed consent projects on GLP-1s and bariatric surgery.

MSSI is working on a version of this resource for kids! If you are interested in contributing to our work, please reach out to sizeinclusivemedicine@gmail.com.

Upcoming Event: MSSI Advocacy in Clerkships and Residency Interviews

Thursday, November 6, 2025, 8:00pm ET (via Zoom)

As advocates, we often find ourselves in conversations with those whose views or beliefs may not be aligned with our own. While such conversations can be an important part of advancing any important cause, this dynamic can be especially challenging when being evaluated, such as during residency interviews and clerkships. Medical Students for Size Inclusivity (MSSI) is hosting this event to foster connection and communication between student advocates and to provide a space for students to share their experiences and tips on speaking about size-inclusive advocacy. Together, we can empower and support each other as we all take the next step in our medical careers!

This event is only open to students.

Healers, Educators, Students, and Activists Convene in Community at Association for Weight and Size Inclusive Medicine’s Inaugural Fall Symposium

On October 24th 2025, size-inclusive healthcare professionals, educators, activists, and students gathered for the Association for Weight and Size Inclusive Medicine (AWSIM)’s first annual fall symposium, “Building Community – Supporting Patients and Each Other.” The symposium featured educational presentations, panel discussions, and a networking and community-building session, facilitating valuable opportunities for connection and education. 

The virtual symposium opened with a presentation by AWSIM’s president Dr. Lisa Erlanger, which was followed by a clinical practice didactic led by Dr. Stephanie Hart. These were followed by panel discussions moderated by Dr. Erin Knopf and AWSIM’s Education Committee Chair Dr. Anna Whelan. Panel topics included size-inclusive advocacy in medical education and perspectives on sustaining advocacy and self-care in today’s medical climate. Panel speakers consisted of MSSI Co-Director Jessica Rosenblum, MSSI Curriculum Lead Abigail Faust, AWSIM Vice President Dr. Katarina Wind, UMass Clinical Psychologist Dr. Cathryn Williams, Harvard Medical School Instructor and Family Medicine Physician Dr. Madhuri Rao, Family Medicine Physician Dr. Anna Mirer, NAAFA Executive Director Tigress Osborn, and Angel Austin, Founder of Sacred Space for Fat Bodies.

Educational elements of the symposium focused on communicating a vision of healthcare aimed at supporting bodies of all sizes, rather than care aimed simply at mitigating barriers in a medical system that remains intent on pathologizing and eliminating fat and disabled bodies. In Dr. Erlanger’s opening presentation, “Beyond the Blood Pressure Cuff,” examples of improper vaccine administration and drug dosing were cited to demonstrate that lack of evidence and poor practice guidelines likely play a significant role in perpetuating health disparities traditionally blamed on being higher weight. Erlanger described the necessity of advocacy that moves beyond “access” (to appropriately sized blood pressure cuffs, needles, and gowns) and towards the direct challenge and dismantling of weight stigma. Only once we create a more equitable system, rather than improving access to the current, flawed, system, can research, policy, and education truly advance effective and compassionate care for the fat body. In “Sexual Function: The Intersection of Medical and Societal Weight Stigma,” Dr. Hart contributed to this vision with a presentation that shared evidence of weight bias within physician communities, argued against BMI-based management of sexual dysfunction, and described a potential road map to weight-inclusive sexual health counseling that is trauma-informed, accessible, and inclusive.

Community-building was another key feature of the event. Panelists shared memorable stories of advocating for size-inclusive and weight-neutral care in their own clinical practices, classrooms, and personal lives. A lively Zoom group chat contributed a steady stream of resources, encouragement, and wisdom. The symposium ended with virtual breakout groups that allowed participants to socialize, share advice, and learn from each other. Topics that emerged from these parts of the event included the importance of supporting medical trainees experiencing weight stigma or disordered eating, opportunities for supporting medical staff and assistants in accessing education about size-inclusive care, funding organizations with liberatory fat politics, and leveraging personal stories as a powerful way to advocate for systemic change. Throughout it all, participants’ stories emphasized the importance of turning towards community both as a means of support and an act of resistance. 

As one participant described, "resistance means accepting that we are interconnected, and that our health outcomes depend on more than our individual choices…ultimately, there is no one intervention that makes us immune to the impact of genetics, biology, and their interaction with our environment, a realization that fundamentally disrupts our individualistic culture.” 

A full recording of the symposium will be made available for free for AWSIM members. MSSI students are entitled to free AWSIM membership; contact us at sizeinclusivemedicine@gmail.com for more information on how to access all that AWSIM has to offer.

Crowd-Sourced Symposium Resources:

• CDC Vaccine Needle Length Guide

• JAMA 2021 – Surgeons who completed just 10 operations on higher weight people significantly reduced their patients’ “elevated” risk of post-operative infections and complications 

• MSSI GLP-1 Agonist Informed Consent Project

• MSSI Bariatric Surgery Informed Consent Project

• More of Me to Love

• Fat Self Care

• Prescribing GLP-1 Agonists for Weight Loss: Wrestling with Our Philosophical Angst

• The o**sity wars and the education of a researcher: A personal account

• Let’s Eat – Be Real USA

• FLARE Project: Finding Accessible Imaging for Fat Bodies

• Friendly Like Me: Find and Review Accessible Places

• Weight and Wisdom: Reflections on Decades of Working for Body Liberation

• A Psalm for the Wild Built

Organizations to Donate To:

• NAAFA

• Sacred Space for Fat Bodies

Did you attend AWSIM’s Fall 2025 Symposium? Let us know your thoughts.

This newsletter was authored by MSSI member Jay Liu (Stanford University)

HAPPENING THIS WEEK: Size Inclusive Pediatric Medicine

Thursday, October 30 at 12:00-1:30pm EST (via Zoom)

Join MSSI and AWSIM to learn about the harms of weight-centric care in pediatrics, and to explore how weight-inclusive approaches can provide a refreshing alternative framework of care that uplifts children, their families, and their care teams. The session will include an initial presentation of the evidence behind the weight-inclusive approach, followed by a panel discussion with physicians who practice weight-inclusive healthcare with pediatric populations.

The AWSIM Fall Symposium 2025 is happening THIS WEEK!

Friday, October 24th, 12-5pm ET

All eyes on the upcoming AWSIM Fall Symposium! Hear from a variety of speakers on relevant topics within weight inclusive care. Join AWSIM and MSSI for an afternoon of connection, learning, and collective care, centered on what it means to show up for our patients and for each other in this work.

Main Sessions:

• Weight Inclusive Medicine presented by AWSIM Board (1 hr)

• Topics in Clinical Practice (1 hr)

• Weight Inclusive Care and Medical Education (1 hr)

• Advocacy and Lived Experience Panel (1 hr)

• Breakout sessions & Networking (1 hr)

FREE for students and AWSIM members!

Medical education event co-hosted by MSSI student leaders, Jessica Rosenblum and Abigail Faust.

In this issue:

• Upcoming Events!

• Book Review: Fearing the Black Body by Sabrina Strings + Belly of the Beast by Da’Shaun Harrison

Upcoming Events

Size Inclusive Pediatric Medicine

Thursday, October 30 at 12:00-1:30pm EST (via Zoom)

Join MSSI and AWSIM to learn about the harms of weight-centric care in pediatrics, and to explore how weight-inclusive approaches can provide a refreshing alternative framework of care that uplifts children, their families, and their care teams. The session will include an initial presentation of the evidence behind the weight-inclusive approach, followed by a panel discussion with physicians who practice weight-inclusive healthcare with pediatric populations.

Learning objectives:

1. Defining the problem – Establish the existence of weight stigma in pediatric healthcare 

2. So What? – Review the harms perpetuated by weight stigma in pediatrics

3. Taking action – The case for providing weight/size inclusive pediatric healthcare

Speakers:

Taka Yamaguchi, MD Taka Yamaguchi is a Primary Care Pediatrician and grassroots organizer living and working in the Boston, Massachusetts area. Born in Japan, he grew up in Massachusetts before setting off for the cornfields of Washington University in St. Louis for his undergraduate degree and the University of Illinois in Chicago for medical school, then to Brown University for his Pediatrics residency. Since returning to the Bay State, he has been working to practice patient-centered, weight-neutral pediatric care in a healthcare industry that is often at odds with these goals. He is passionate about medical education, adolescent health, and building a more human society together. He is indebted to many mentors across the country and the world, and walks in the footsteps of those who came before him and those who walk alongside him. You might find him playing violin in his band, swimming in any swimmable body of water, or cooking up something seasonal and yummy for his friends and family.

Wendy Schofer, MD, FAAP, DipABLM, PCC, TIPC, NBC-HWC Wendy Schofer, MD, FAAP, DipABLM, PCC, TIPC, NBC-HWC is the pediatrician-founder of Family in Focus, where it is her mission to help 1 million parents relieve stress, strengthen relationships with food, body, and family, and design homes where health feels easy, joyful, and connected. Finally, help without harm.

Geraldine Malana, DO, MA, MPH Geraldine Malana, DO, MPH, is a Family Medicine Physician at Cambridge Health Alliance, Clinical Faculty of the Tufts Family Medicine Residency Program, Clinical Instructor at Tufts University School of Medicine. She received her DO/MPH from A.T. Still University in Arizona and completed her residency at Northwestern McGaw Family Medicine Residency at Humboldt Park in Chicago. Geraldine's professional interests include health equity, weight inclusive care, and osteopathic medicine in primary care.

AWSIM Fall Symposium 2025

Friday, October 24th, 12-5pm ET

All eyes on the upcoming AWSIM Fall Symposium! Hear from a variety of speakers on relevant topics within weight inclusive care. Join AWSIM for an afternoon of connection, learning, and collective care, centered on what it means to show up for our patients and for each other in this work.

Main Sessions:

• Weight Inclusive Medicine presented by AWSIM Board (1 hr)

• Topics in Clinical Practice (1 hr)

• Weight Inclusive Care and Medical Education (1 hr)

• Advocacy and Lived Experience Panel (1 hr)

• Breakout sessions & Networking (1 hr)

FREE for students and AWSIM members!

Introduction to Health at Every Size® by ASDAH

Thursday, October 23, 2025, 1:00-2:00pm ET

Since the Fat Liberation movement began in the 1960s, activists have provided critical analyses about how weight is used in accessing, and the provision of, healthcare. This critique developed into what would eventually be called the Health at Every Size® (HAES®) Principles, drawing thousands of healthcare professionals to reconsider what is accepted as care for people in larger bodies.

The Health at Every Size® approach to healthcare is based on four Health at Every Size® Principles and a Framework of Care. Together they provide a path for healthcare providers to learn about and practice ethical and effective care for larger people. This session will introduce the four principles and ten components of the framework to serve as the foundation of Health at Every Size®-aligned care.

This session is designed for healthcare providers who are brand new to Health at Every Size® but we welcome everyone to join in the conversation!

MSSI Advocacy in Clerkships and Residency Interviews

Thursday, November 6, 2025, 8:00pm ET (via Zoom)

Medical Students for Size Inclusivity (MSSI) is hosting this event to foster connection and communication between student advocates as residency interview season begins and as other students continue to work hard on their clinical rotations. As advocates, we often find ourselves in conversations with those whose views or beliefs may not be aligned with our own. While such conversations can be an important part of advancing any important cause, this dynamic can be especially challenging when being evaluated, such as during interviews and clerkships. As the leaders of MSSI, we want to provide a place for medical students to share experiences and tips for speaking about their advocacy work in interviews or in clinical settings so other students can feel empowered and supported as we all take the next step in our medical careers.

Book Review: Fearing the Black Body by Sabrina Strings and Belly of the Beast by Da’Shaun Harrison

By MSSI member Jay Liu (Stanford University)

While preparing for board exams this summer, I found myself turning towards reading as a way to recharge and finished several books that had been high on my list, namely Sabrina String’s Fearing the Black Body: The Racial Origins of Fatphobia and Da’Shaun Harrison’s Belly of the Beast. Together, they offer a rigorous interrogation of the historical and contemporary entanglements of race, fatness, and medical discourse. Challenging dominant assumptions about body size and health, Strings and Harrison position fatphobia not as an individual concern, but as a structural system of oppression rooted in anti-Blackness.

Fearing the Black Body draws on art, literature, religious doctrine, and medical texts to trace the evolution of European and American cultural attitudes toward body size. Renaissance artists idolized the “plump” female form as an aesthetic embodiment of the divine, but a cultural preference for leanness emerged alongside European colonial expansion and the transatlantic slave trade. As easier access to sugar through the slave trade transformed a substance formerly limited to aristocrats into a publicly accessible good, food restriction (and the leaner bodies that could, in some cases, result) became fashionable among the white European elite as a demonstration of religious, moral, and intellectual superiority. Together with the “discovery” of southern African women with naturally robust bodies (Saartjie Baartman as the famous example), fatness became increasingly linked with Blackness, and a larger body with moral, intellectual, and physical inferiority. Within the North American colonies too, thinness was promoted by the church, popular magazines, and eugenicists as an indication of both race and class distinction. 

Medicine didn’t involve itself in the topic of body size until the nineteenth and early twentieth centuries. At its onset, greatest concern was placed on the weak, sickly frames of the white American elite, occupied by an obsession with thinness at all costs (notably, medical professionals were unconcerned with the health of Black women or other people of color). However, modern medicine evolved in conversation with dominant cultural, religious, and scientific powers, and by the early twentieth century, cultural fatphobia had become codified into the medical discourse.

Our contemporary cultural and medical obsession with thinness is rooted in anti-Blackness and has culminated in the contemporary “o**sity epidemic,” a narrative Strings argues is less scientific truth than cultural myth. The epidemic was famously launched off an infamous CDC article warning that “o**sity” is a significant (and presumably reversible) cause of death in the American population, illustrating its point with a photograph of a larger-bodied black woman being measured by a provider with thin white hands. Despite internal objections raised within the CDC as to the study’s methods and conclusions, mounting scientific evidence that excessive weight loss is unsustainable, and demonstration that health-supporting behaviors and communities impact morbidity and mortality independent of any weight loss, the “o**sity epidemic” captured global and cultural attention, perpetuating racial and class hierarchies under the guise of health promotion. 

Harrison’s Belly of the Beast builds on this foundation by examining the lived experience of fat Black men within a society that simultaneously eroticizes and criminalizes their bodies. Equal parts vulnerable and revolutionary, Harrison begins their narrative by unraveling the sexual and gender politics of their assault at the hands of a babysitter. They transition to an analysis of the sizeism inherent in cultural debates surrounding the Black Lives Matter movement, arguing that fatphobia operates as a form of state-sanctioned violence, evident both in patterns of police brutality and medical neglect. Victims of police violence, Harrison points out, were to be reliably described by their murderers in subsequent investigations as “large” and therefore “threatening,” their deaths taking place in the context of a cultural narrative that paints the large Black man as a “beast” to be caged and conquered. “Health” is also perverted to justify death, echoing dominant cultural representations of health as a choice/responsibility, and poor health as a personal and moral failing: Had George Floyd not had asthma or cardiovascular disease, Harrison writes, his murderers claim he could have survived the extended choke hold in which he was placed. What Floyd was NOT though, before being placed in a police chokehold, was both sick and dead. Harrison ultimately rejects depoliticized calls for “body positivity,” instead advancing a radical framework that demands dismantling the structural conditions—racism, ableism, cisnormativity, and capitalism—that sustain body-based oppression.

Together, Fearing the Black Body and Belly of the Beast critically reframe fatness as a category deeply shaped by racialization and power, underscoring the necessity of interrogating weight stigma not merely as bias, but as an institutionalized practice with direct consequences for patient care and health equity. They are essential reads for the size-inclusive practitioner.

This newsletter was authored by MSSI members Jay Liu (Stanford University) and Sophie Lalonde-Bester (University of Alberta).

In this issue:

• Introducing our Physician Partners: The Association for Weight and Size Inclusive Medicine (AWSIM)

• Meet our MSSI Chapters & Affiliates

• New Study Finds Weight Cycling is Associated with Several Chronic Diseases

• Upcoming Events

Our Physician Partners: The Association for Weight and Size Inclusive Medicine (AWSIM)

We are excited to announce a new collaboration between the Association for Weight & Size Inclusive Medicine (AWSIM) and Medical Students for Size Inclusivity (MSSI).

Together, we are partnering to align medical students and physicians in the fight against weight discrimination and to promote weight-inclusive, equitable care for patients of all sizes. This collaboration ensures our advocacy and leadership extend across every stage of medical training and practice.

All members of MSSI are now also members of AWSIM! This is a new international professional physician-led organization and non-profit working to advance weight-inclusive care.

Benefits of the AWSIM membership for students include:

• Free attendance to AWSIM Events

• Access to weight-inclusive medicine research articles and resources online

• Subscription to monthly newsletter

• Opportunity to participate on AWSIM’s members only forum

• Adding AWSIM Membership under “Professional Organizations” on CV

• Opportunities for mentorship and project collaborations

Instagram post

Meet the MSSI Chapters & Affiliates

Thank you to those who joined us on August 26 for our chapters and affiliates meet & greet! We had so much fun getting to know everyone and are so inspired by the hard work of our chapter leaders across the USA and Canada.

Current chapters & affiliates:

• MSSI at Hackensack Meridian School of Medicine

• MSSI at University of Minnesota - Twin Cities Medical School

• Health Professional Students for Size Inclusivity, an Affiliate of MSSI (University of California San Francisco School of Medicine)

• Size Inclusivity in Medicine at University of Wisconsin - School of Medicine and Public Health, an Affiliate of MSSI

• MSSI at Washington State University Elson S. Floyd College of Medicine

• MSSI at Tufts University School of Medicine

• MSSI at University of Nevada Reno SOM

• MSSI at Cooper Medical School of Rowan University

• MSSI at Frank H. Netter MD School of Medicine at Quinnipiac University

• Medical and Dental Students for Size Inclusivity at Harvard Medical School, An Affiliate of MSSI

• Columbia Students for Size Inclusivity, An Affiliate of MSSI (Columbia University)

• MSSI at University of Washington School of Medicine

• MSSI at UC Davis School of Medicine

• MSSI at Albany Medical College

• MSSI at University of British Columbia

• Students for Body Acceptance and Food Freedom (SBAFF) at Oregon Health & Science University, An Affiliate of MSSI

Interested in bringing MSSI to your school? Click below for those wanting to 1) form a chapter of Medical Students for Size Inclusivity (MSSI) at your school, or 2) affiliate an existing organization at your school with MSSI. Once received, a member of MSSI will reach out with additional details, and our Chapter & Affiliate Application form! 

Evidence-Based Archives

MSSI is excited to present another instalment of “Evidence-Based Archives,” our column highlighting and summarizing seminal research in the field of size-inclusive healthcare. In this section, we hope to celebrate our scholars, empower each other with knowledge, and stock up on citations for the next time we’re called upon to justify size-inclusive healthcare in the classroom, clinic or wards! 

Note: This month’s evidence-based archives has also been published in AWSIM’s student highlights.

Content warning: Medicalized fatphobia

This month’s highlight: 

Alison Z Swartz, Kathryn Wood, Eric Farber-Eger, Alexander Petty, Heidi J Silver, Weight Trajectory Impacts Risk for 10 Distinct Cardiometabolic Diseases, The Journal of Clinical Endocrinology & Metabolism, 2025;, dgaf348, https://doi.org/10.1210/clinem/dgaf348

This recently published large cohort study examined how different weight trajectories (including weight stability, weight gain, weight loss, or weight cycling) relate to the development of several common cardiometabolic diseases among adults with similar baseline BMI. Using de-identified electronic health records from Vanderbilt University Medical Center spanning 1997–2020, researchers applied multivariate Cox proportional hazards regression to track associations for over 83,000 patients.

Key findings included the following:

• Compared to weight stability, weight cycling was linked to significantly higher risk of several conditions, including:

  • Heart failure [hazard ratio (HR) 1.54; 95% confidence interval (CI) 1.31, 1.82]

  • Obstructive sleep apnea (HR 1.28; 95% CI 1.15, 1.42)

  • MASLD (HR 1.28; 95% CI 1.08, 1.51)

  • Type 2 diabetes (HR 1.23; 95% CI 1.10, 1.38)

• Both weight gain and weight loss also raised the risk of heart failure, compared to weight stability.

• Importantly, baseline BMI was the same in all groups, meaning the impact of weight cycling on the risk for developing these cardiometabolic diseases was not merely driven by ‘high’ body mass.

This study draws strength from its large, real-world dataset (>83,000 participants!) spanning more than two decades and its rigorous analytic methods, which allowed for meaningful comparisons across weight trajectory groups with similar baseline BMI. However, the reliance on electronic health records means the intentionality behind weight changes, such as dieting versus illness, cannot be distinguished (though, patients with cancers were intentionally excluded for this reason). There are also the theoretical intrinsic limitations of using electronic health records such as data entry errors.

Overall, this paper underscores the harms of repeated weight loss attempts and weight cycling, which are often encouraged in clinical settings. This is especially relevant now with the rise in popularity of GLP-1 receptor agonist drugs. We know very well that for people living in larger bodies, weight cycling is not simply a matter of “non-adherence,” but a predictable consequence of biologically driven weight regain after intentional weight loss. Rather than continuing to promote weight loss at all costs, this study can be cited to:

• advocate for weight-neutral, stability-focused care that supports cardiometabolic health without prescribing unsustainable dieting,

• highlight how weight cycling, not high body size alone, contributes to increased disease risk, and

• encourage clinicians to focus on sustainable health behaviours (balanced nutrition, physical activity, sleep, stress management, equitable access to care) instead of repeated, harmful weight loss attempts.

Have thoughts?
We are open to feedback and interested in the lived experiences of our MSSI members. Have you referenced this article in your clinical work, used it to guide patient counseling, or used it to communicate with your colleagues? How did it go? 

Feel free to share your stories, reflections, expertise, and advice using the link below. With your permission, we may publish reflections in future installments of this column.

If you have a favourite article you’d like us to highlight in our next installment, feel free to submit it for consideration, also by using the link below! We look forward to hearing from you.

Upcoming Events

AWSIM Fall Symposium 2025

Friday, October 24th, 12-5pm ET

All eyes on the upcoming AWSIM Fall Symposium! Hear from a variety of speakers on relevant topics within weight inclusive care. Join AWSIM for an afternoon of connection, learning, and collective care, centered on what it means to show up for our patients and for each other in this work.

Main Sessions:

• Weight Inclusive Medicine presented by AWSIM Board (1 hr)

• Topics in Clinical Practice (1 hr)

• Weight Inclusive Care and Medical Education (1 hr)

• Advocacy and Lived Experience Panel (1 hr)

• Breakout sessions & Networking (1 hr)

FREE for students and AWSIM members!

An Interdisciplinary Discussion of GLP1 Medications in Clinical Practice

Thursday, September 25 at 5:30pm EST

Panelists: Andrea Westby MD, Larissa Ens RD, Marissa Langton, Vincci Tsui RD

FREE for students and AWSIM & WIDIC members!

SAVE THE DATE: Weight Inclusive Pediatric Care (MSSI x AWSIM)

Thursday, October 30 at 12:00-1:30pm EST (via Zoom)

More details to come!

This newsletter was authored by MSSI member Sophie Lalonde-Bester (University of Alberta).

In this issue:

• Introducing the 2025-2026 MSSI Leadership Team

• Did you attend the annual International Weight Stigma Conference?

• AWSIM Fall Symposium

Introducing the New MSSI Leadership Team

We’re excited to introduce ourselves as the new leadership team for Medical Students for Size Inclusivity (MSSI) for the 2025–2026 academic year! It’s an honour to carry forward the work of this growing, passionate community committed to advancing size-inclusive care in medicine.

Whether you identify as someone in a larger body, as some of us on the leadership team do, or you’re an ally, whether you’re just beginning to engage in this work or have been advocating for years, we’re so glad you’re here. MSSI is a space for learning, action, and connection, and we welcome everyone with open arms.

We also want to acknowledge the exciting momentum within our broader community. As many of you know, the Association for Weight and Size Inclusive Medicine (AWSIM) launched last year and is already making waves. We’re thrilled about the opportunities for collaboration and synergy with AWSIM, while continuing to center the unique voices and needs of student advocates—just as our name reflects.

We look forward to learning and growing with all of you this year!

Jessica Rosenblum Co-Director Jessica “Jess” Rosenblum is a 3rd year MD/MPH student at Tufts University School of Medicine who grew up in New Jersey surrounded by her loving parents, grandparents, and sisters. She received her bachelor’s degree from Washington University in St. Louis in 2020, where she studied Anthropology/Global Health, and French. After graduating, Jess worked in health policy at Mathematica in Washington, DC, where her policy work focused on reproductive and maternal health, Medicaid, and health equity. While Jess has always lived in a larger body herself, her formal advocacy in this area began when she started medical school at Tufts in 2023. Jess co-launched a chapter of MSSI at Tufts, successfully advocated for curricular changes, and later became a lecturer within the Tufts curriculum to teach other medical students about weight-inclusive care. She is also involved in several qualitative and quantitative research projects related to weight bias and inclusive care. Jess hopes to become a full-spectrum family physician, delivering high quality care to individual patients while continuing to advocate for sweeping improvements to the healthcare system and advancing access, quality, and equity of care for all.

Anna Wengyn Co-Director Anna Wengyn is a co-director of MSSI. She is beginning her M3 year at Cooper Medical School of Rowan University. She became interested in size inclusive medicine after her own experiences as a fat patient left her feeling shamed and isolated, causing her to disengage with the healthcare system as a patient but engage as a future physician. She is most interested in pediatrics because that patient population is in a formative time of life regarding self-esteem and body image, and she hopes to be a positive presence for young patients to encourage health at every size.

April Ascher Secretary I am a M2 at the University of Kansas School of Medicine at their Salina campus. Our campus is the smallest in the country with about 8 students per class! I still haven’t decided which career path I want to pursue yet, but I am considering family medicine with either a geriatric or palliative care fellowship or psychiatry. I came to size inclusive medicine because as someone who lives in a larger body, I have experienced medical trauma and want my future patients to have better care than I have in the past. For fun I like to read, play flute, write poetry, and spend time with my family and my partner. A fun fact about me: when I was young I raised rabbits for 4-H and had over 200 rabbits at one point!

Taylor Lees Director of Community Engagement & Education Taylor (she/her) is a rising fourth-year medical student at the University of Minnesota. She earned her MPH prior to medical school, where she began her work in health equity and weight-inclusive health advocacy. Taylor has been involved with MSSI throughout medical school, serving at both the national level and as co-president of the UMN chapter. She is committed to advancing holistic, equity-driven care that addresses physician bias and social determinants of health. Outside of medicine, she enjoys reading, exploring Minneapolis, and spending summers at the lake.

Sophie Lalonde-Bester Newsletter Co-Chair Sophie (she/her) is an incoming fourth-year medical student at the University of Alberta in Canada with hopes to pursue a career in family medicine. Her clinical background as a registered dietitian and research on eating disorders and polycystic ovary syndrome have shaped her commitment to size-inclusive care. She is responsible for MSSI’s monthly newsletter. Outside of medicine, she loves to run and be in the mountains.

Jay Liu Newsletter Co-Chair Jay Liu (they/them) is a fourth-year medical student at Stanford University. They came to size-inclusive medicine after learning about HAES through an eating disorder prevention program (shoutout to Christina Miranda's Body Empowerment Project!), and they haven't been able to look back since! Their goal is to one day be a size-inclusive, LGBTQ-friendly family medicine provider who can help folks feel at peace with amazing, ever-evolving bodies and nurture a gentle, loving relationship with food. Along the way, they plan to do many fun and cool things like read all the anti-diet books, explore the world with their partner, and engage in their own eating disorder recovery journey one step at a time. They can be reached at jliu99@stanford.edu

Joe Morrison Research Lead Joe is a third-year MD/PhD student at UC Davis. His PhD is in biomedical engineering with research interests in bone mineral density, joint mechanics, and health equity. He currently serves as the MSSI Research Lead to advance student-lead projects on weight bias in medicine and medical education.

Abby Fraust Curriculum/Education Lead Abby is an M3 at Drexel University College of Medicine. Word-of-mouth brought her to an MSSI event, and she was instantly hooked. After a lifetime of watching her family yo-yo diet (and yo-yo diet herself) for the sake of body image and ‘health’, the weight-inclusive space was a breath of fresh air. It provided a new, sustainable way to engage with food and body image. She looks forward to sharing this framework with her patients - in GI, primary care, or who knows! She loves to lift, bake for friends, and scour Facebook marketplace.

Sam Temucin Director of Chapters and Affiliates Sam Temucin is an M4 at the Philadelphia College of Osteopathic Medicine, planning to pursue General Surgery. Her commitment to size inclusivity is deeply rooted in her own mental health journey and a recognition of the harm caused by weight stigma in medicine, particularly within surgical fields. Since joining MSSI in 2022, they have found both community and a platform to advocate for change. Outside of medicine, she enjoys rock climbing and spending time with her partner, their two cats, and close friends in Philadelphia.

Jackie Liu Advocacy Co-Lead Jackie (she/they) is a rising third-year at Harvard Medical School and Co-Advocacy Lead for MSSI. Jackie grew up in Maryland and majored in Biology and Women’s Studies at the University of Maryland, where they found passions in student organizing, reproductive justice, health policy, and fat studies/liberation. Their senior thesis was on healthcare providers’ attitudes towards larger-bodied patients and how that’s reflective of a larger, fatphobic society. Because of this, she pursued medicine to not only practice weight-inclusive healthcare, but also systemically change how we practice health to include bodies of all sizes. In her free time, Jackie likes to crochet, bake, and weightlift!

Marisa Langton Advocacy Co-Lead Hi all! I’m Marisa Langton, a fourth-year medical student at Drexel College of Medicine. Before medical school, I studied nutrition and worked as a size-inclusive personal trainer, where I developed a deep passion for promoting positive health behaviors. My commitment to weight inclusivity first began during my own eating disorder recovery and has since become a central pillar of my personal and professional advocacy. In my future career, I aim to continue promoting positive health behaviors specifically through a weight-neutral lens, helping to build a system that provides more equitable and comprehensive care to patients of all sizes. Outside of medicine, you can usually find me reading memoirs, making homemade pasta, or doing something active like lifting weights or trail running!

Did you attend the 11th Annual International Weight Stigma Conference? We want to hear from you!

The 11th Annual International Weight Stigma Conference has just wrapped up, and what an incredible event it was! Our med student community continues to push the boundaries of weight-inclusive research, practice, and advocacy on a global scale, and we couldn’t be prouder.

Did you attend? Present? Follow the conversations online? We’d love to feature your experience in the next issue of the MSSI newsletter!

If you were part of the conference in any way this year, we’d love for you to share:

• Photos from the event

• Research highlights or key takeaways

• Personal reflections or stories

• Summaries or recaps of your favourite sessions

• Or anything else you’d like to share!

👉 Click here to share your experience!

We'd love to feature your reflections, highlights, and stories in the next MSSI newsletter. You can submit as much or as little as you like — whether it's a photo, a standout research presentation, or a brief recap of your experience.

Association for Weight and Size Inclusive Medicine (AWSIM) Fall Symposium

Friday, October 24th, 12-5pm ET

Hear from a variety of speakers on relevant topics within weight inclusive care. Join AWSIM for an afternoon of connection, learning, and collective care, centered on what it means to show up for our patients and for each other in this work.

Main Sessions:

• Weight Inclusive Medicine presented by AWSIM Board (1 hr)

• Topics in Clinical Practice (1 hr)

• Weight Inclusive Care and Medical Education (1 hr)

• Advocacy and Lived Experience Panel (1 hr)

• Breakout sessions & Networking (1 hr)

FREE for students and AWSIM members!

This newsletter was authored by MSSI member Sophie Lalonde-Bester (University of Alberta).

In this issue:

• 11th Annual Weight Stigma Conference: Share Your Experience!

• Call for Student Collaborators: Tackling Weight Bias in Medical Simulations

• Save the Date: AWSIM Fall Symposium

• Find AWSIM on Instagram

Are you attending the 11th Annual International Weight Stigma Conference? We want to hear from you!

6-7 JULY 2025 GOLD COAST, AUSTRALIA & ONLINE

The 11th Annual International Weight Stigma Conference is just around the corner, and we’re thrilled to see our med student community continue pushing the boundaries of weight-inclusive research, practice, and advocacy on a global scale.

Are you attending? Are you presenting? Are you following any of the conversations online? We want to feature your experience in our next issue of the MSSI newsletter!

If you are a medical student attending the conference this year in any capacity, we’d love for you to share:

• Photos from the event

• Research highlights or key takeaways

• Personal reflections or stories

• Summaries or recaps of your favourite sessions

• Or anything else you’d like to share!

👉 Click here to share your experience!

We'd love to feature your reflections, highlights, and stories in the next MSSI newsletter. You can submit as much or as little as you like — whether it's a photo, a standout research presentation, or a brief recap of your experience.

Call for Student Collaborators: Tackling Weight Bias in Medical Simulations

Are you passionate about improving medical education?

MSSI faculty advisors Dr. Anna Whelan and Dr. Cathryn Williams are partnering with faculty and standardized patient (SP) educators at UMass Chan to evaluate and address weight-biased language and framing in early clinical learning experiences (ECLs) and OSCEs.

We're looking for MSSI students interested in joining this initiative to help identify areas for improvement and contribute to creating more inclusive, equitable learning environments. If you're interested or want to learn more, we’d love to connect! Let us know at sizeinclusivemedicine@gmail.com.

Save the Date: AWSIM’s Fall Symposium (Virtual)

We’re so excited to share that AWSIM’s first official symposium is happening this fall!

Mark your calendars for Friday, October 24th, 2025, from 12–4pm EST, live on Zoom. 

The theme this year is “Building community – Supporting patients and each other.”

Find AWSIM on social media!

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This newsletter was authored by MSSI member Sophie Lalonde-Bester (University of Alberta).

In this issue:

• LAST CHANCE to apply for the 2025 NAAFA Scholarship

• Registration is open for the 11th Annual Weight Stigma Conference

• Upcoming AWSIM Event: Knee Replacements and BMI Cutoffs

• Resource Highlight: MSSI Mini-Guides!

• Find us on Instagram

DEADLINE IS TODAY (JUNE 1) for the 2025 Dr. Paul Ernsberger Research Scholarship!

The mission of the National Association to Advance Fat Acceptance is to change perceptions of fat and end size discrimination through advocacy, education, and support. 

The goal of the Dr. Paul Ernsberger Research Scholarship is to provide financial support to graduate students currently enrolled in a graduate program with an accredited U.S. college or university. Dr. Ernsberger’s decades of research on metabolic syndrome, diabetes, weight cycling, and the medical harm caused by diet obsession and weight bias has had an immeasurable impact on debunking myths and misunderstandings about fat and health. It is an honor for NAAFA to support the continuation of his important work by supporting graduate students who hope to carry on and advance Dr. Ernsberger’s legacy.

Up to three scholarships in the amount of $2,500 will be awarded.

Areas of concentration in scientific laboratory research:

• Nutrition and higher weight people

• Metabolic syndrome

  • Insulin resistance/diabetes

  • Hypertension

  • Hyperlipidemia

• Weight cycling

• Medical harm from being obsessed with weight loss

• Medical harm from the bias of physicians

Prioritization will be given to applicants of marginalized identity (POC, LGBTQIA+, disabled, fat/superfat) and those who demonstrate financial need. Scholarship will be paid directly to the graduate student.

REQUIREMENTS:

• Online application

• Transcripts (unofficial are acceptable)

• Proof of enrollment

• Recommendation/Reference form(s) - At least one recommendation/reference other than your advisor

• Copy of your FAFSA Student Aid Report

TIMELINE:

• Filing deadline 6/1/25

• Evaluators' recommendations by 6/18/25

• NAAFA BOD vote by 6/28/25

• Decision letter and agreement sent by email by 7/7/25

• Returned signed agreements by 7/14/25

• Scholarship issued 7/21/25

Scholarship winners will be required to sign an agreement and submit a written report or mutually agreed upon report-back outlining your research progress, no later than the end of the 2025/2026 academic year.

Call for Abstracts: 11th Annual International Weight Stigma Conference

6-7 JULY 2025 GOLD COAST, AUSTRALIA & ONLINE

Deadline for abstract submission: Rolling/June 20, 2025

Conference registration is open (student pricing and travel bursaries available)

The Annual International Weight Stigma Conference is an interdisciplinary event that brings together scholars and practitioners from a range of backgrounds (e.g., public health, government and public policy, psychology, medicine, sociology, anthropology, allied health professions, education, sports and exercise science, social sciences, media studies, business, law, activism, and the lay public) to consider research, policy, rhetoric, and practice around the issue of weight stigma.

Abstracts can be for oral presentations (10 mins, including time for questions), posters, or other formats (symposia, workshops, seminars, creative sessions, etc.).

They invite contributions across a wide range of disciplines and methodological and theoretical approaches. International voices discussing the situation in countries other than the US are particularly welcome. Equally so are intersectional approaches and perspectives from other marginalized groups. We encourage submissions from scholars, practitioners, policy makers, and activists. Students are especially encouraged to submit proposals.

Judges’ Choice and People’s Choice prizes will be awarded for the best oral presentation and best poster.

Note, accepted presenters will be required to register for the conference and pay the registration fee. Bursaries may be available on a case-by-case basis.

Visit the abstract submission page for more information.

AWSIM June Journal Club with Ragen Chastain: Knee Replacements and BMI Cutoffs

Tuesday June 10th at 5:30pm PT

FREE for AWSIM Members and students, $35 for non-members

Resource Highlight: MSSI Mini-Guides

Did you know? MSSI has a series of Mini-Guides that are brief informational sheets centered around specific topics within the realm of size inclusive medicine! You might find them useful to your learning and/or advocacy work.

We have Mini-Guides on the following topics:

• What to do if a patient asks about weight or weight loss?

• Do GLP-1 agonists fit into a size-inclusive model of healthcare?

• What is diet culture?

Please let us know if there are additional topics you would like to see us cover.

GLP-1RA Mini Guide

Find us on social media!

Instagram post

This newsletter was authored by MSSI member Sophie Lalonde-Bester (University of Alberta).

In this (bonus!) issue:

• Scholarship Opportunity: NAAFA 2025 Dr. Paul Ernsberger Research Scholarship

Applications are open for the 2025 Dr. Paul Ernsberger Research Scholarship!

The mission of the National Association to Advance Fat Acceptance is to change perceptions of fat and end size discrimination through advocacy, education, and support. 

The goal of the Dr. Paul Ernsberger Research Scholarship is to provide financial support to graduate students currently enrolled in a graduate program with an accredited U.S. college or university. Dr. Ernsberger’s decades of research on metabolic syndrome, diabetes, weight cycling, and the medical harm caused by diet obsession and weight bias has had an immeasurable impact on debunking myths and misunderstandings about fat and health. It is an honor for NAAFA to support the continuation of his important work by supporting graduate students who hope to carry on and advance Dr. Ernsberger’s legacy.

Up to three scholarships in the amount of $2,500 will be awarded.

Areas of concentration in scientific laboratory research:

• Nutrition and higher weight people

• Metabolic syndrome

  • Insulin resistance/diabetes

  • Hypertension

  • Hyperlipidemia

• Weight cycling

• Medical harm from being obsessed with weight loss

• Medical harm from the bias of physicians

Prioritization will be given to applicants of marginalized identity (POC, LGBTQIA+, disabled, fat/superfat) and those who demonstrate financial need. Scholarship will be paid directly to the graduate student.

REQUIREMENTS:

• Online application

• Transcripts (unofficial are acceptable)

• Proof of enrollment

• Recommendation/Reference form(s) - At least one recommendation/reference other than your advisor

• Copy of your FAFSA Student Aid Report

TIMELINE:

• Filing deadline 6/1/25

• Evaluators' recommendations by 6/18/25

• NAAFA BOD vote by 6/28/25

• Decision letter and agreement sent by email by 7/7/25

• Returned signed agreements by 7/14/25

• Scholarship issued 7/21/25

Scholarship winners will be required to sign an agreement and submit a written report or mutually agreed upon report-back outlining your research progress, no later than the end of the 2025/2026 academic year.

In this issue:

• Community Artwork

• Evidence-Based Archives

• Find us on Instagram!

Community Artwork

This month, MSSI is proud to feature a moving original submission by April Ascher (she/her)!

Original artwork may be submitted to the MSSI newsletter to be considered for publication. Submissions are reviewed on a monthly basis. All forms of artwork are welcome! We look forward to receiving your work!

Evidence-Based Archives

MSSI is excited to present another installment of “Evidence-Based Archives,” our monthly column highlighting and summarizing seminal research in the field of size-inclusive healthcare. In this section, we hope to celebrate our scholars, empower each other with knowledge, and stock up on citations for the next time we’re called upon to justify size-inclusive healthcare in the classroom, clinic or wards!

Content warning: Medicalized fatphobia, ob*sity, anti-fat language

Disclaimer: We use the terms “ob*sity” and “overw*ight” in our summaries when it is otherwise impossible to accurately describe findings from certain studies, due to the language and descriptors chosen by researchers. We acknowledge the inaccuracies and harms that these labels have perpetuated in medicine and society. Please keep your mental health in mind when reading, and feel free to reach out to us with any feedback or suggestions at any time!

This month’s highlight:

Diabetes management (Type 2 in particular) is arguably one of the greatest movers and shakers of medical practice. For better or worse, most medical providers have advice to offer their patients who are living with T2DM, and while information access can be a good thing, it also means that generalizations and stereotypes surrounding diabetes counseling/treatment are rampant.

Generalizations are commonplace in medicine, passed along from well-meaning attendings to residents and medical students. Yet whether because of oversimplification or the not-so-subtle influence of the diet industry in healthcare, many common diabetes recommendations can also feel fat-phobic, unintentionally promote shameful/avoidant food behaviors, and worse of all, be based in very limited evidence!

This month, MSSI hopes to highlight some medical oversimplifications surrounding Type 2 diabetes and additional evidence/recommendations to consider the next time you are approaching counseling and treatment for this condition. As a brief disclaimer, this is a HUGE topic that cannot possibly be covered in a short article! We will provide links and resources to follow up if you want to further explore, and please write in and provide feedback if we missed something that you think would be great to address — it might even get featured in our next article!

Oversimplification #1: Weight loss is the most effective way to treat type 2 diabetes

• Research repeatedly demonstrates that weight loss via a diet and exercise approach is ineffective in the long term. (1, 2)

• Researchers have identified weight-stigma as a significant factor worsening everything from medication adherence to long-term health outcomes for individuals diagnosed with Type 2 diabetes. (3)

• Weight-loss research does not control for the impact of lifestyle modifications that may otherwise be impacting health. (4, 5)

Practice recommendation: Encourage health-supporting behaviors that genuinely promote and support long-term wellbeing and happiness. Refrain from suggesting that weight loss is a prerequisite to pursuing or achieving a meaningful, well-rounded, and “healthy” life. Suggestions for health-supportive, weight-inclusive diabetes practices include challenging weight-stigma, engaging in joyful movement, spending time with supportive loved ones, going to therapy, and fueling your body. Additionally, consider de-stigmatizing the role of medications in supporting overall health. An un-medicated body is not “better” than a medicated one (we are all only temporarily able-bodied, after all!) 

Oversimplification #2: Pre-diabetes 

Diabetes is technically a risk factor, not a disease — most folks with HbA1C > 6.5% are asymptomatic (6.5 was defined to be the cutoff based only on projected likelihood of developing symptomatic retinopathy). That’s why practice guidelines for successful diabetes management don’t advocate for the reduction of HbA1C to below 6.5, but maintenance of the value to somewhere between 7-8%, with additional nuance based on an individual’s overall state of health and projected lifespan. Managing diabetes can play a role in supporting overall health. But pre-diabetes management (managing a risk factor for developing a risk factor) is actually more controversial.

• “Pre-diabetes” is a diagnostic category created in 2010 by the American Diabetes Association by lowering the cutoff for “impaired glucose tolerance.” This was done, theoretically out of consideration that “early detection” could reduce diabetes-associated morbidity and mortality. However, the lower cutoff was controversial and contested by multiple professional groups, including the World Health Organization, because the change created a large, poorly defined patient group that included low-risk individuals unlikely to benefit from medical intervention. (6) The change also made it such that the prevalence of “impaired glucose tolerance” in the population doubled, fueling concerns for rising rates of glucose intolerance in the US despite the fact that the rate at which diabetes is being diagnosed in the US population has been declining since 2009. (7,8)

• 2/3 (66%) of people diagnosed with pre-diabetes remained non-diabetic at the 10-year mark. (6)

• There is some evidence that initiating medication (such as with metformin) in the setting of prediabetes can delay the development of diabetes by ~2years, but it has NOT been shown to prevent the development of diabetes. (6) It has definitely increased profits for drug companies, though!

• “Pre-diabetes” diagnoses in otherwise healthy individuals (and widening disease definitions in general) have been demonstrated to contribute to stress-related conditions and an overburdened medical system. (9)

Practice recommendation: Older adults (age > 65) do not need to be medically treated for pre-diabetes, a recommendation that is also supported by AAFP practice guidelines (9). When discussing a diagnosis of pre-diabetes in any age group, consider including some of the above context (including actual risk of progression to diabetes).

Oversimplification #3: If you have diabetes, you shouldn’t eat carbs

Anyone who’s trained in an inpatient unit has “carb-controlled diet” and “insulin sliding-scale” drilled into their brain as must-have items on the plans for patients with diagnosed diabetes. Unsurprisingly, this philosophy carries over to the outpatient setting, where carbohydrate restriction is the most commonly cited piece of advice for managing diabetes (and more recently, pre-diabetes). Carbohydrate restriction may make sense in the short term to lower blood glucose levels, but:

• Low carbohydrate diets have not been shown to reliably impact measures of glucose tolerance in the long-run. (10)

• Dietary guidelines framed as restriction are more likely to promote disordered eating behaviors and damage rapport between patients and providers. Unsurprisingly, they are also are less likely to be observed. 

• Other ways of managing a meal’s immediate glycemic impact (for patients with severe diabetes) include consuming protein and veggies before or alongside the carbohydrate part of a meal, or going on a gentle post-meal walk to aid digestion. (11, 12)

Practice recommendation: Encourage patients to fuel their bodies with a wide variety of foods and to explore tastes/flavors/textures outside their comfort zone. All foods are important and play a role in supporting our mental/emotional/social/physical health, so try to include protein, fruit/veg, AND carbs in most meals! Health-supporting meals can be created in the context of any cultural practice or tradition. 

1. _{Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost AT, Gulliford MC. Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Am J Public Health. 2015 Sep;105(9):e54-9. doi: 10.2105/AJPH.2015.302773. Epub 2015 Jul 16. PMID: 26180980; PMCID: PMC4539812.}

2. _{Nordmo M, Danielsen YS, Nordmo M. The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments. Obes Rev. 2020 Jan;21(1):e12949.}

3. _{Potter L, Wallston K, Trief P, Ulbrecht J, Juth V, Smyth J. Attributing discrimination to weight: associations with well-being, self-care, and disease status in patients with type 2 diabetes mellitus. J Behav Med. 2015 Dec;38(6):863-75. doi: 10.1007/s10865-015-9655-0. Epub 2015 Jul 2. PMID: 26133488; PMCID: PMC4628883.}

4. _{Aphramor L. Validity of claims made in weight management research: a narrative review of dietetic articles. Nutr J. 2010 Jul 20;9:30.}

5. _{Rothblum E.D. Slim chance for permanent weight loss. Archives of Scientific Psychology. 2018;6(1):63–69.}

6. _{Yudkin JS, Montori VM. The epidemic of pre-diabetes: the medicine and the politics. BMJ. 2014 Jul 15;349:g4485. doi: 10.1136/bmj.g4485. Erratum in: BMJ. 2014;349:g4683. PMID: 25028385; PMCID: PMC4707710.} 

7. _{https://archive.cdc.gov/www_cdc_gov/diabetes/library/reports/reportcard/national-state-diabetes-trends.html}

8. _{https://archive.cdc.gov/www_cdc_gov/diabetes/research/reports/cdc-research-20yr-report.html}

9. _{https://www.aafp.org/pubs/afp/issues/2021/1200/p649.html}

10. _{Landry MJ, Crimarco A, Gardner CD. Benefits of Low Carbohydrate Diets: a Settled Question or Still Controversial? Curr Obes Rep. 2021 Sep;10(3):409-422. doi: 10.1007/s13679-021-00451-z. Epub 2021 Jul 23. PMID: 34297345; PMCID: PMC9621749.}

11. _{Kubota S, Liu Y, Iizuka K, Kuwata H, Seino Y, Yabe D. A Review of Recent Findings on Meal Sequence: An Attractive Dietary Approach to Prevention and Management of Type 2 Diabetes. Nutrients. 2020 Aug 19;12(9):2502. doi: 10.3390/nu12092502. PMID: 32825124; PMCID: PMC7551485.}

12. _{Engeroff T, Groneberg DA, Wilke J. After Dinner Rest a While, After Supper Walk a Mile? A Systematic Review with Meta-analysis on the Acute Postprandial Glycemic Response to Exercise Before and After Meal Ingestion in Healthy Subjects and Patients with Impaired Glucose Tolerance. Sports Med. 2023 Apr;53(4):849-869. doi: 10.1007/s40279-022-01808-7. Epub 2023 Jan 30. PMID: 36715875; PMCID: PMC10036272.}

Thoughts?

We are open to feedback and interested in the lived experiences of our MSSI members. Have you referenced this article in your clinical work, used it to guide patient counseling, or used it to communicate with your colleagues? How did it go? 

Feel free to share your stories, reflections, expertise, and advice using the links below. With your permission, we may publish reflections in future installments of this column.

If you have a favorite article you’d like us to highlight in our next installment, feel free to submit it for consideration, also by using the link below! We look forward to hearing from you!

Find us on social media!

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This newsletter was authored by MSSI members Sophie Lalonde-Bester (University of Alberta) and Jay Liu (Stanford University).